PecFent® is used to treat breakthrough pain (a temporary flare in pain) related to cancer. The possible benefits of treatment vary; your doctor, nurse, or pharmacist will be happy to answer any questions you have about your treatment.

This leaflet should be read together with the manufacturer’s patient information leaflet. For further guidance on using the spray, visit www.medicines.org.uk/emc search ‘Pecfent,’ then click ‘Patient Leaflet’ under ‘Pecfent 100’ or ‘Pecfent 400’ (depending on your prescribed dose) and then click ‘audio/video.’

What is PecFent®?

PecFent® is a nasal spray which contains a drug called fentanyl, a strong opioid painkiller. As it is absorbed quickly it has the potential advantage of providing rapid pain relief. You will only be prescribed PecFent® if you are already prescribed a regular strong opioid painkiller (such as morphine, fentanyl or oxycodone).

How do I take PecFent®?

The bottle should be primed before it is used – please see the manufacturer’s patient information leaflet for more information on how to do this. The bottle is ready to use when a green bar can be seen in the window.

Place the nozzle of the spray a small distance (around 1 centimetre) into the nostril. A spray can then be delivered by pressing and releasing the grips on either side of the nozzle. You will hear a click, and the number displayed on the counter will move on; you may not feel the spray, and should rely on the counter number to confirm that a spray has been delivered. If the dose that you are taking requires 2 sprays, then spray 1 dose into each nostril.

What dose of PecFent® is usually prescribed?

The starting dose is 100 micrograms of PecFent®. This is because the effects vary from person to person and the dose is increased based on how effective it is at managing your pain.

  • If your pain was not controlled on 100 micrograms, for the next breakthrough pain episode use 2 x 100 microgram sprays (1 in each nostril). If effective continue to use this dose.

  • If 2 x 100 microgram sprays (1 in each nostril) was not effective for pain relief, then you may need to be prescribed a bottle of PecFent® 400 micrograms per spray and use 1 x 400 microgram spray for your next episode of breakthrough pain.

  • If this dose was not effective, increase to 2 x 400 microgram sprays (1 in each nostril).

You can take up to 4 doses of PecFent® in a 24-hour period. Sometimes, this may differ but the maximum number of doses will be agreed between you and the healthcare professional managing your pain. You must leave at least 4 hours between doses.

Can I take PecFent® with my other medications?

All of your medications will be reviewed when you are prescribed PecFent®, and you will be advised whether you will continue with any medication that you have previously been prescribed for pain.

PecFent® may interact with some medications, including certain antifungal drugs such as fluconazole, and the antibiotics clarithromycin and erythromycin. You should also avoid grapefruit juice while you are prescribed this medicine.

Use of PecFent® and sedative medicines such as benzodiazepines or related drugs increases the risk of drowsiness, and difficulties in breathing (respiratory depression). If you are taking any sedative medicines, you will be carefully monitored for side-effects.

If you have any queries or concerns about PecFent® and other medicines you are taking, you can discuss with your doctor, specialist nurse or pharmacist. Further information is available in the manufacturer’s patient information leaflet which is supplied with the medication.

What are the possible risks/side-effects?

Side effects may include; tiredness, sleepiness, sickness, constipation and confusion. If you take too much please seek medical attention urgently because PecFent® can slow your breathing pattern. If this is not treated, it can be potentially fatal. Signs of overdose include slow or shallow breathing, loss of

consciousness, extreme drowsiness, and feeling very dizzy or confused. Phone 999 if you experience these symptoms.

Is PecFent® addictive?

Most patients do not suffer from addiction when PecFent® is started appropriately and reviewed alongside your pain. However, there have been some reports of addiction to these fentanyl preparations. Risk of addiction is lower when the medication is used as discussed with the prescriber, at the correct dose

and time. Please discuss this with your doctor, specialist nurse or pharmacist if you would like further information.

What is the length of treatment and plan for follow-up?

The length of treatment will depend on your symptoms. You will be regularly reviewed to assess whether the PecFent® needs to continue or the dose needs to be altered. We will agree together who will continue to review your pain. You will either be reviewed by The Christie supportive care team or a local service if this is available.

Do I need to have any tests or special monitoring when taking PecFent®?

There are no routine tests required. The healthcare professional managing your pain will want to make sure that your blood tests have been checked prior to starting treatment to make sure there are no issues with your kidney and liver function.

Can I drive if I am taking PecFent®?

PecFent® may affect your mental and/or physical ability to perform potentially hazardous tasks such as driving or operating machinery. It may be an offence to drive if your ability to drive safely is affected by taking this medicine. You should not drive after starting PecFent® or after a dose change until you have had a discussion with your doctor regarding whether this is advisable and safe.

Can I drink alcohol?

PecFent® can make you feel sleepy, and alcohol will add to this. We advise that you avoid alcohol. If you would like any further information please discuss this with your doctor, specialist nurse or pharmacist.

Who will first prescribe PecFent®?

PecFent® will be prescribed by the supportive care team. It will be agreed between the supportive care team and your GP or other local service who will issue further prescriptions.

How do I get further prescriptions for PecFent®?

PecFent® is a specialist medicine and is not readily available from your community pharmacy; who require advance notice to order it.

If your GP is willing to prescribe PecFent®, please do not leave it too late to request a prescription. You must request a prescription at least 72 hours in advance of you running out of medication to give your GP and community pharmacist time to arrange. Please allow extra time at weekends and bank holidays.

If you are attending The Christie supportive care or pain clinic for follow up, PecFent® may be dispensed by The Christie Pharmacy. You should be given enough supply to last you until your next review.

If you run out of PecFent® and are unable to get a further supply, you must contact the supportive care team for advice.

How should PecFent® be stored?

Please keep the sprays in their original packaging out of the reach of children or anyone else who might take them by mistake, and if they are consumed seek urgent medical attention by calling 999. When taken as directed and under medical supervision, PecFent® is safe for you. However, it is dangerous, potentially fatal, if they are taken by someone they are not prescribed for. Any unused medication can be returned to any pharmacy for safe disposal.

Other useful information

  • see the patient information leaflet inside the product box for picture instruction of how to use

  • the bottle should be primed before first use

  • do not blow your nose immediately after using PecFent®

  • if the product has not been used for 5 days it will need re-priming by spraying once

  • do not use once the spray has been opened for more than 60 days

  • • after use, replace the protective cap and place the spray bottle back into the child-resistant container

Who should I phone if I need urgent advice about PecFent®?

Monday to Friday, 8am to 4pm contact the supportive care team on 0161 446 3072 or 0161 446 3639. For urgent advice out of these hours or at weekends and bank holidays, contact The Christie Hotline on 0161 446 3658 (24 hours a day, 7 days a week).

Useful contacts