Fentanyl
(Date: December 2022. Version: 3)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
Quick read
Fentanyl might very occasionally be prescribed in pregnancy to treat severe pain if other drugs have not worked.
What is it?
Fentanyl (Abstral®, Effentora®, Instanyl®, PecFent®, Fenhuma®, Actiq®, Cynril®, Sublimaze®, Durogesic®, Fencino®, Matrifen®, Mezolar®, Opiodur®, Victanyl®, Yemex®) is used to treat severe, long-term pain. It might also be given as part of an anaesthetic during surgery.
What are the benefits of using fentanyl in pregnancy?
Fentanyl is a very strong painkiller and might control severe pain where other painkillers have not.
What are the risks of using fentanyl in pregnancy?
Very few pregnant women taking fentanyl have been studied. Although the available information does not suggest fentanyl affects the baby’s development, more research is required to rule out problems.
Fentanyl used around the time of delivery can affect the baby after birth. The baby may be ‘jittery’, have feeding problems, and initially need some help with breathing. These problems usually settle within the first few days.
Pregnant women who take fentanyl should contact their GP or pain specialist as soon as possible. Their doctor will review whether fentanyl is still needed and ensure that the dose is correct. Pregnant women should not stop taking fentanyl or change the dose without speaking to a health care professional.
Are there any alternatives to using fentanyl in pregnancy?
Possibly. Other medicines can be used to treat pain in pregnancy. However, if a doctor has offered fentanyl, this will be based on several factors, including which painkillers have already been tried, the likelihood of a medical condition not being as well-controlled with another painkiller, and possible side effects if the medicine is changed. Women who have any questions about a medicine that they are offered in pregnancy should speak to their doctor or midwife.
What if I prefer not to take medicines during pregnancy?
Severe pain can greatly affect quality of life. It can cause difficulty sleeping and mental health problems. Doctors may suggest use of fentanyl in pregnancy if they think that the benefits of controlling pain outweigh any possible risks to the baby.
Will I or my baby need extra monitoring during pregnancy?
Women in the UK will be offered a very detailed scan at around 20 weeks of pregnancy as part of routine antenatal care. Taking fentanyl in pregnancy is not expected to cause problems that would require any extra monitoring of a baby prior to birth.
Babies who were exposed to fentanyl in the womb before delivery will be more closely monitored for a while after birth to ensure that they are breathing and feeding as normal.
Are there any risks to my baby if the father has taken fentanyl?
We would not expect any increased risk to your baby if the father takes fentanyl.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org
How can I help to improve drug safety information for pregnant women in the future?
Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit https://www.medicinesinpregnancy.org/Login/ to register.
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General information
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.
www.medicinesinpregnancy.org