Onsolis is a discontinued dosage form of fentanyl, a prescription opioid with a significant risk for tolerance, dependence, addiction and overdose.

Onsolis was a dosage form of fentanyl. The medication came as a film that could dissolve in the mouth. However, the drug has been discontinued by its manufacturer. Although other forms of oral fentanyl exist, including tablets and liquids, no oral film of fentanyl is manufactured any longer. For this reason, any Onsolis is likely to be expired or a black market drug.

Article at a Glance:

  • Onsolis is a now-discontinued form of fentanyl, a potent opioid
  • By triggering the brain’s reward system, fentanyl can cause addiction
  • Side effects are similar to other opioids and can include slowed breathing, which can be deadly
  • Quitting opioids like Onsolis is best done in a medical detox and rehab setting to avoid withdrawal symptoms

Onsolis Addiction

Onsolis contained fentanyl, a potent opioid. Fentanyl is listed under the Controlled Substance Act in the United States as a Schedule II controlled substance and has a high potential for addiction and abuse. Refills of prescription drugs on this list are not allowed, and only a doctor who is licensed to prescribe opiates can prescribe this powerful painkiller. Opioids like fentanyl trigger the brain’s feel-good chemical dopamine and the brain’s reward system. This creates a risk for addiction.

What is Onsolis?

Onsolis was a pain-relieving medication intended for cancer patients who experienced breakthrough pain and had developed a tolerance for other types of opioid pain management. Onsolis was applied directly to the inside of the cheek using water-soluble polymeric films.

Because Onsolis was so strong, individuals who were not already on a chronic opioid therapy schedule were not prescribed the drug because it could cause life-threatening respiratory depression and death.

Signs, Symptoms & Side Effects of Abuse

Common side effects associated with Onsolis included nausea, constipation, vomiting, dizziness and drowsiness. Like other opioids, it could also lead to respiratory depression, or slowed breathing, especially if misused or taken with interacting substances. Slowed breathing can be fatal and is the main cause of death from an opioid overdose. Hundreds of medications are known to have drug interactions with Onsolis. Some, like benzodiazepines, can significantly increase the risk of slowed breathing when taken with Onsolis.

Onsolis Overdose

Onsolis was intended for use by opioid-tolerant individuals who had taken daily doses of potent opioids for at least a week before starting Onsolis. Disregarding this protocol greatly increased the risk of overdose because Onsolis was so potent.

An overdose can come on suddenly and quickly lead to life-threatening complications if left untreated. Pinpoint pupils, reduced levels of consciousness, and respiratory depression are collectively referred to as the “opioid overdose triad.” Other signs of Onsolis overdose included cold, clammy skin, low blood pressure and purple/blue lips and fingernails.

If someone is having an opioid overdose, naloxone can be given. Naloxone, also known as Narcan, is an opioid antidote and is usually given as a nasal spray.

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

Long-Term Consequences

One common long-term effect of using opioids like Onsolis is the development of tolerance. This means that you need to take higher doses of the opioids to get the euphoric feeling you may have had when first starting the drug. In addition, taking opioids like Onsolis over the long-term can lead to dependence. The body gets used to the opioid being present, and if the person tries to cut back or stop taking the drug, uncomfortable withdrawal symptoms can occur.

Onsolis Withdrawal

If you want to quit taking Onsolis, you should first set up a meeting with your doctor before stopping. Stopping cold-turkey can cause withdrawal symptoms, especially if you use the drug regularly. This can make it even harder to stay sober. A doctor may be able to help you manage your opioid withdrawal symptoms by prescribing an alternative like methadone, buprenorphine or a buprenorphine/naloxone combination. These treatments, sometimes called medication-assisted therapy or MAT, can be used long-term to curb cravings and help you stay sober.

Withdrawal Symptoms

Although withdrawal symptoms can vary from patient to patient, severe withdrawal symptoms can include:

  • Muscle and bone pain
  • Sleep problems
  • Diarrhea
  • Vomiting
  • Cold flashes with goosebumps
  • Uncontrollable leg movements
  • Severe cravings

Withdrawal Timeline

The half-life of a drug refers to how much time it takes before half of a single dose is cleared from your body. Onsolis’s half-life is about 14 hours. Because it generally takes five half-lives to completely clear a drug from your system, Onsolis can stay in your body for almost three days.

You may start to experience withdrawal symptoms after the first missed dose. However, all patients experience the withdrawal timeline differently, since each patient has a unique physiology. Other factors, such as how long you have been using Onsolis and your Onsolis dosage levels, may also affect how quickly withdrawal symptoms subside.

Because managing opioid withdrawal symptoms can be difficult, you may want to seek a medically-assisted detoxification program. In this type of program, patients detox in a controlled environment with access to medical professionals during the withdrawal process.

Onsolis Addiction Treatment & Detox

Substance abuse treatment programs vary based on an individual’s needs and the severity of their addiction. Some people may complete treatment on an outpatient basis, while others may need more intensive care, such as residential treatment.

Onsolis Medical Detox

Medical detox is the first step to quit Onsolis. Although it may be tempting to try to wean yourself from Onsolis on your own, this can be very hard. Medical detox takes place in an inpatient setting with round-the-clock medical support to come off of Onsolis safely. Further, medical detox helps you manage your withdrawal symptoms. Because unmanaged withdrawal symptoms are linked to problems staying sober, a medical detox program can improve your chances of long-term success.

Onsolis Rehab

For the best chance of long-term sobriety, rehab should follow a medical detox program. Medical detox weans you safely off Onsolis, but rehab is needed to teach you the coping skills to live life without the drug. Many different rehab options are available, depending on your needs.

Inpatient Rehab
An inpatient treatment program allows patients to live onsite at designated inpatient centers while they work to overcome their substance use disorder. Inpatient rehab can be especially helpful for patients with a severe Onsolis addiction or those who may find recovery difficult due to distractions from home or a difficult living environment.

Outpatient Rehab
Once a patient completes inpatient rehab, they will enter outpatient programming. This program allows patients to live at home and ease back into the outside world while they attend scheduled treatment appointments. Patients with a less severe Onsolis addiction may opt to entirely skip inpatient rehab and begin recovery with the outpatient option.

Choosing an Onsolis Rehab Center

Choosing a rehab center is an important step in each individual’s journey to a substance-free life. It is recommended that patients consult with their doctors before making this important decision.

If you or someone you love is struggling with Onsolis addiction, The Recovery Village specializes in treating opioid addiction. To learn more about our life-saving programs, contact a helpful representative 24 hours a day.

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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

Food and Drug Administration. “Onsolis.” December 2016. Accessed July 15, 2020.

Drugs.com. “Onsolis (fentanyl) drug interactions.” Accessed July 15, 2020.

Schiller, Elizabeth; Goyal, Amandeep; Cao, Fei; Mechanic, Oren. “Opioid Overdose.” StatPearls, March 29, 2020. Accessed July 15, 2020.

National Institute on Drug Abuse. “Fentanyl DrugFacts.” February 2019. Accessed July 15, 2020.

Hallare, Jericho; Gerriets, Valerie. “Half Life.” StatPearls, January 30, 2020. Accessed July 15, 2020.

Anne Arundel County Department of Health. “Naloxone: Frequently Asked Questions.” Updated September 19, 2018. Accessed July 15, 2020.

Sinha Rajita. “New Findings on Biological Factors Predi[…]elapse Vulnerability.” Current Psychiatry Reports, October 2011. Accessed October 5, 2019.

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.