Some prescribers have ordered fentanyl transmucosal buccal tablets (Fentora) inappropriately to treat acute pain, such as headaches or back pain in patients who aren't opioid-tolerant. These tablets are indicated only for management of breakthrough chronic pain in cancer patients who are already receiving and tolerant to opioids. At least three patients who received the drug inappropriately developed respiratory failure and died. Improper substitution of Fentora for other fentanyl products such as transmucosal lozenges has also contributed to patient injury.

Fentanyl bioavailability is higher in the buccal tablet, so a patient being switched to these tablets from another fentanyl oral product such as lozenges shouldn't be getting the same dose in micrograms because it could result in a fatal overdose. Learn more about the medication and the risks at http://www.fda.gov/medwatch/safety/2007/safety07.htm#Fentora.