Fentora is a dissolvable form of fentanyl, a potent opioid with a high risk of abuse, dependence and addiction. Withdrawing from Fentora generally requires medical detox.

Fentanyl (contained in Fentora) is an extremely potent synthetic opioid. Generally reserved for severe pain such as pain from cancer, doctors only prescribe Fentora for people who are tolerant to other opioids. As such, fentanyl is an opioid that can put a person at high risk of abuse, dependence and addiction.

Article at a Glance:

  • Fentora is a brand name for dissolvable fentanyl tablets, an opioid product with a high overdose risk even compared to other opioids
  • As a Schedule II controlled substance, Fentora is highly addictive
  • Side effects are similar to other opioids but can also include pain or sores in the mouth
  • Medical detox can help ease withdrawal symptoms for people who want to stop taking Fentora

Fentora Addiction

Fentora is classified as an opioid analgesic, or narcotic, and is a Schedule II drug due to a high risk of abuse and dependence. Fentora is highly addictive and has a high overdose potential.

Over time, someone taking Fentora will start building up a tolerance to the medicine as their body gets used to it. Higher tolerance for opioids means a higher dose may be needed to achieve the same results. You can still develop a physical dependence or psychological addiction to the drug even when taken exactly as directed by your doctor.

Fentora is part of the Transmucosal Immediate Release Fentanyl (TIRF) Risk Evaluation and Mitigation Strategy (REMS) Access program. The program is designed to reduce the occurrences of overdose and serious complications due to medical errors. Patients must be enrolled in the TIRF REMS Access program before they are considered eligible for treatment with Fentora.

What is Fentora?

Fentora is one of the brand names for fentanyl, a potent opioid painkiller. Opioids like Fentora reduce pain by affecting how the brain and body experience and respond to it. Many dosage forms of fentanyl exist, and the brand name Fentora specifically refers to dissolvable oral tablets.

Fentora is a short-acting drug that is FDA-approved to treat breakthrough pain in cancer patients who are already taking a long-acting opioid. Breakthrough pain is a sudden, intense pain that occurs despite the patient following a pain treatment regimen consisting of other opioids.

Signs, Symptoms & Side Effects of Abuse

Common side effects of Fentora are similar to those of other opioids and include:

  • Constipation
  • Nausea
  • Vomiting
  • Drowsiness
  • Dizziness
  • Dry mouth
  • Headache
  • Sores in the area of the mouth where Fentora dissolves

If a person begins to misuse the drug, they may show some behavioral signs like taking Fentora more frequently than prescribed or taking it in higher amounts than prescribed.

If a person is struggling with addiction, they may begin having withdrawal symptoms when they stop taking Fentora and have strong urges or cravings for it. Other signs of addiction could include irritability, constantly seeking out the drug and risking problems with the law while trying to obtain it.

Fentora Overdose

Even compared to other opioids, Fentora puts people who take it at high risk of overdose, thus the drug’s TIRF program that requires both doctors and patients to register before it can be prescribed. Further, the FDA requires that doctors and pharmacists ask about children in the home who may have access to Fentora. Children are at high overdose risk and the drug should be stored securely away from their access.

Peak overdose risk when taking Fentora starts between 15 and 30 minutes after you take a dose and can last for several hours. Overdose symptoms are similar to that of other opioids and include:

  • Slowed breathing
  • Worsening drowsiness
  • Limp muscles
  • Cold and clammy skin
  • Pinpoint pupils

If you believe you are witnessing an overdose, you should administer naloxone immediately and call 911.

Fentora and Alcohol

Fentora should not be combined with alcohol. Because both substances depress the central nervous system, there is a high risk for patients consuming them together to suffer from an overdose, coma or even death.

Fentora Withdrawal

If you take Fentora regularly, you will often become physically dependent on the drug, even if you are taking it as prescribed. Physical dependence means that a person’s brain becomes accustomed to the drug’s presence. If the drug is suddenly stopped, the brain’s chemical balance is thrown off. Withdrawal symptoms are likely to occur at this stage if a person stops taking the drug.

Withdrawal Symptoms

Withdrawal symptoms are caused by the sudden alteration in chemical balance once the drug is no longer in the body. Fentora can cause unpleasant and sometimes painful physical and psychological withdrawal symptoms, including:

  • Nausea
  • Vomiting
  • Anxiety
  • Problems sleeping
  • Hot or cold flashes
  • Sweating
  • Cramps
  • Runny eyes and nose
  • Diarrhea

During withdrawal, someone who is physically dependent on Fentora will have uncontrollable cravings and be tempted with recurring use; however, a substance-free life is possible and attainable at The Recovery Village.

Withdrawal Timeline and Symptom Duration

The withdrawal timeline is hard to pinpoint and can vary by person. In general, the more physically dependent you are on a drug, the worse your withdrawal symptoms will be. If you take Fentora regularly, symptoms can occur between 8 and 24 hours after the last dose and can last for 4 to 10 days.

Managing Fentora Withdrawal Symptoms

The safest way to manage Fentora withdrawal symptoms is to receive help from professional detox and rehabilitation centers.

Recovering from opioid addiction is very challenging because the withdrawal symptoms are very powerful. This makes it difficult to cope with withdrawal on your own. Medical detox centers can offer medicine to treat or prevent withdrawal symptoms, making withdrawal much more bearable.

Fentora Addiction Treatment & Detox

When detoxification from Fentora is attempted without help, the results can lead back to substance misuse and could be dangerous to the person’s mental and physical health. Withdrawal symptoms can become so intolerable that they create new or worsening issues, like anxiety. That is why medical supervision at a detox center is critical to long-term recovery and health.

Rehabilitation Programs

The Recovery Village has many resources and programs for patients looking to live a healthier, substance-free life. Regardless of whether a patient begins recovery with inpatient or outpatient rehab, they will first be required to detox from Fentora safely. Once the drug has been removed from the patient’s system, they will benefit from counseling opportunities and recreational activities at The Recovery Village.

Inpatient Rehab
Inpatient rehab allows patients to live on campus at one of The Recovery Village’s designated inpatient treatment centers. This is helpful for patients with severe Fentora addiction or those who may find it difficult to recover from Fentora addiction due to distractions at home. While in the inpatient rehab program, patients have access to trained professionals who can teach them techniques on how to manage their unique struggles with addiction.

Outpatient Rehab
After completing the inpatient rehab program, patients typically begin outpatient rehab. This program allows patients to live at home while they come to The Recovery Village for scheduled treatment appointments. Some patients with less severe addiction may choose to begin treatment with the outpatient option.

Choosing a Rehab Center

Opioid recovery is stressful for everyone involved and this further complicates finding the right detox center. It is important to note, a detox program that worked for one person might not be as effective for another person. Patients’ needs vary depending on their unique situations.

At The Recovery Village, our medical team and available resources allow us to design a recovery program to meet you or your loved one’s individual needs. Access to medications helps to alleviate uncomfortable withdrawal symptoms and provide our patients with the space to focus on long-term recovery with a clear mind. Our group therapy sessions offer guidance and advice from people who are overcoming the same challenge. Individual therapy is available to help patients address the root of their addiction, as well as ways to cope with stress to stay in recovery after leaving the center.

To learn more, contact us to speak with a representative and find the closest facility near you. We can help you take the first steps towards living a drug-free life today.

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Editor – Melissa Carmona
Melissa Carmona puts years of writing and editing experience to work helping people understand substance abuse, addiction and mental health disorders. Read more
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Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more
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FAQs & Related

How is Fentora used?

Fentora is available as a dissolving oral tablet. It is designed to be placed under the tongue, above a rear molar, or between the upper cheek and gum. The tablet should not be crushed or chewed and usually fully dissolves within 25 minutes. The medication is only given to cancer patients who are used to and experienced with narcotics and if the patient is taking other narcotics daily for around-the-clock pain.

Fentora has a high risk of addiction, so it is important to take the medication exactly as prescribed to reduce the risk of substance misuse.
It is initially started at a dose of 100 mcg as needed and can be gradually increased by a doctor if breakthrough pain is severe. It is not recommended to take more than two tablets during one breakthrough episode. Taking more than prescribed can result in severe side effects and possibly cause an overdose.

In the event of an emergency, should naloxone be administered to reverse a Fentora overdose?

Opioid antagonists like naloxone are given to reverse the effects of Fentora in the event of an overdose. It is usually given as a nasal spray sold under the brand name Narcan, but also comes as an injectable sold under the brand name Evzio. It can be used when an overdose victim has symptoms like:

  • Slow or no breathing
  • Unconsciousness and not waking up

If you give naloxone to someone, you should always call 911. This is true even if the person seems to get better after you have given naloxone. Naloxone starts to work within 3 minutes. However, the drug wears off within 90 minutes. Therefore, it is possible for someone to stop breathing again after naloxone wears off.

How long does Fentora stay in your system?

Fentanyl can be found in your body for different periods of time, depending on what is being tested:

  • Urine: Fentanyl stays in the urine for up to 3 days after its last use.
  • Blood and plasma: The drug can be found in the blood for up to 12 hours after its last use. Further, its major breakdown product norfentanyl can be found in the blood for up to 10 hours after the last use.
  • Saliva: It is not clear how long fentanyl is detectable in saliva.
  • Hair: Fentanyl is present in hair. In general, 1.5 inches of hair growth shows the past 90 days of drug use.

U.S. National Library of Medicine. “Fentora.” October 11, 2019. Accessed July 25, 2020.

World Health Organization. “Clinical Guidelines for Withdrawal Manag[…]e in Closed Settings.” 2009. Accessed July 25, 2020.

Anne Arundel County Department of Health. “Naloxone: Frequently Asked Questions.” Updated September 9, 2019. Accessed July 25, 2020.

ARUP Laboratories. “Drug Plasma Half-Life and Urine Detection Window.” January 2019. Accessed July 25, 2020.

Griswold MK, Chai PR, Krotulski AJ, et al. “A Novel Oral Fluid Assay (LC-QTOF-MS) fo[…]rted Heroin Overdose.” Journal of Medical Toxicology, December 2017. Accessed July 25, 2020.

Salomone A, Palamar JJ, Bigiarini R, et al. “Detection of Fentanyl Analogs and Synthe[…]in Real Hair Samples.” Journal of Analytical Toxicology, May 1, 2019. Accessed July 25, 2020.

Gryczynski J, Schwartz RP, Mitchell SG, et al. “Hair Drug Testing Results and Self-repor[…]sk Illicit Drug Use.” Drug and Alcohol Dependence, May 17, 2014. Accessed July 25, 2020.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.