Drug Database
FE

fentanyl (Fentanyl Dura / fentanyl, Lavipharm / fentanyl, Recordati)

✓ Approved

Lavipharm · OPRD1 · Small Molecule

What is fentanyl?

fentanyl is a small molecule developed by Lavipharm. It is approved for therapeutic indications via transdermal.

Drug Profile

Brand NamesFentanyl Dura, fentanyl, Lavipharm, fentanyl, Recordati
CompanyLavipharm
Drug ClassSmall Molecule
Molecular TargetOPRD1, OPRK1, OPRM1
RouteTransdermal
StatusApproved
Sources: ClinicalTrials.gov, Lavipharm

Mechanism of Action

Molecular Targets

fentanyl acts on 3 molecular targets:

OPRD1opioid receptor delta 1 (DOR, OPRD)
OPRK1opioid receptor kappa 1 (KOR1, OPRK)
OPRM1opioid receptor mu 1 (MOR1, LMOR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

fentanyl is developed for 1 unique indication across 1 therapeutic area.

Therapeutic AreaConditionPhase
Gastrointestinal disordersAbdominal pain✓ Approved

Related Research Articles

PubMedRespiratory investigation2026-07-17

Association between fentanyl dose and willingness to undergo repeat bronchoscopy in a standardized EBUS-GS-TBB setting.

Monden Kazuya K, Akamatsu Ayumi A, Takada Yohei Y, Totani Risa R et al.

Discomfort experienced during bronchoscopy may limit patients' willingness to undergo repeat procedures. Although guidelines recommend benzodiazepine-opioid sedation, evidence regarding optimal opioid dosing remains limited. We evaluated whether the total fentanyl dose was associated with willingness to undergo repeat bronchoscopy in a standardized endobronchial ultrasonography with guide-sheath transbronchial biopsy (EBUS-GS-TBB) setting. We conducted a retrospective single-center study of consecutive patients who underwent radial endobronchial ultrasonography with guide-sheath transbronchial biopsy. Patients were categorized by fentanyl dose: none (0 μg), low (1-49 μg), and moderate (≥50 μg). The primary outcome was willingness to undergo repeat bronchoscopy, assessed on a 5-point Likert scale (lower scores indicate greater willingness). Ordinal logistic regression was conducted using complete case analysis. Sensitivity analyses were conducted using alternative dose thresholds and continuous dose modeling. Among 300 patients with evaluable primary outcome data, moderate-dose fentanyl was independently associated with greater willingness to undergo repeat bronchoscopy (adjusted odds ratio, 0.49; 95% confidence interval, 0.27-0.91), whereas low-dose fentanyl was not. The associations remained consistent in direction across different categorizations, and the continuous model demonstrated a dose-response relationship. Severe adverse events included two cases of pneumothorax requiring chest drainage in the moderate-dose group; no other severe events were noted. In this standardized EBUS-GS-TBB setting, moderate-dose fentanyl was associated with greater willingness to undergo repeat bronchoscopy. These findings suggest that willingness to undergo repeat bronchoscopy may depend not only on opioid use, but also on how opioids are titrated.

PMID 42462404
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PubMedbioRxiv : the preprint server for biology2026-07-17

Voluntary oral fentanyl intake produces dose- and sex-dependent physical dependence in mice without overt affective disturbances.

Allichon Marie-Charlotte MC, Boehm Samuel F SF, Jordan Nilah D ND, Nelson Lars H LH et al.

The ongoing opioid epidemic underscores the need for scalable and translational preclinical models of voluntary opioid intake and dependence. We therefore sought to establish and validate a voluntary two-bottle choice drinking-in-the-dark (DID) model of oral opioid intake in mice and to determine relationships between experimental parameters and behaviors during and after withdrawal. Male and female C57BL/6J mice were given daily access to two bottles during the dark phase for 24 drinking sessions over 5 weeks. Control mice received two bottles containing water. Experimental mice received one water bottle and one bottle containing oxycodone (0.1-1 mg/mL) or fentanyl (10-100 µg/mL) under varying session durations and concentrations. On the final day, physical dependence was assessed using naloxone-precipitated withdrawal and then a behavioral battery to assess negative affect was performed in the following week. Mice voluntarily consumed both oxycodone and fentanyl without taste adulteration and maintained drug preference across most concentrations. Oxycodone intake produced minimal withdrawal symptoms. In contrast, fentanyl intake resulted in naloxone-precipitated withdrawal that was modulated by session duration and concentration. Four-hour sessions produced stronger withdrawal than two-hour sessions at equivalent concentrations. Escalating high-concentration fentanyl exposure revealed emerging sex differences, with females exhibiting greater intake and withdrawal at higher concentrations. Affective behavioral assays following withdrawal revealed minimal persistent alterations in any cohort. These findings establish key parameters for a scalable voluntary fentanyl model that produces dose- and session-dependent physical dependence in male and female mice. This paradigm provides a cost-effective and straightforward platform for future investigations of opioid use and dependence.

PMID 42465507
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PubMedHospital pediatrics2026-07-17

Outcomes Associated With Illicit Fentanyl Exposure During Pregnancy: A Retrospective Cohort Study.

Sullivan Kelsey K, Bangiolo Lois L, Kisseih Esther E, Ritter Megan M et al.

Illicitly manufactured fentanyl (IMF) is the predominant opioid in the US drug supply and is a major contributor to morbidity and mortality during pregnancy. While prenatal opioid exposure is an established risk factor for neonatal opioid withdrawal syndrome (NOWS), the differential effects of IMF vs other opioids on outcomes are largely unknown. Therefore, we aimed to evaluate the associations between prenatal IMF exposure and fetal, perinatal, and neonatal health outcomes. We conducted a retrospective cohort study of pregnant women with opioid use disorder (OUD) and their infants who were born between January 2024 and December 2024. Maternal and infant participants were stratified into 2 groups based on the opioids, IMF vs medications for OUD (MOUDs), identified on urine drug testing at delivery. Descriptive statistics were used to describe the characteristics of cohort participants, while χ2 and t tests were used to evaluate for differences in outcomes between the groups. Among 125 infants, 34 were categorized as IMF exposed, and 91 were categorized as MOUD exposed. Fetal growth restriction, preterm birth, and abnormal growth parameters, including low birth weight and very low birth weight, were more frequently identified among IMF- vs MOUD-exposed infants. In addition, IMF-exposed infants were significantly more likely to require neonatal intensive care unit admission, have a longer neonatal hospital length of stay, and require pharmacologic treatment for NOWS. Prenatal IMF exposure was associated with significant neonatal morbidity compared with MOUD exposure, highlighting the importance of engagement in maternal substance use treatment during pregnancy to both maternal and neonatal health outcomes.

PMID 42463150
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PubMedbioRxiv : the preprint server for biology2026-07-17

Stars2Cells: Astrometric Tracking of Neurons Across Imaging Sessions.

Peden-Asarch Ari A, Honan Lauren L, Bai Jacqueline J, Asarch Eli E et al.

Chronic calcium imaging offers a window into how single neurons and ensemble activity change across days where identifying the same neurons from one session to the next is the prerequisite for answering questions regarding learning, drift, and plasticity over time. Yet only ∼2-3% of imaging laboratories publish longitudinal cross-session work, because existing registration tools depend on spatial-footprint or temporal correlations that degrade under repeated recording sessions. Here, we introduce Stars2Cells (S2C) , a tracking pipeline inspired by astrometric plate-solving that represents each neuron's local geometry as a four-dimensional quad descriptor invariant to rotation, translation, and uniform scaling. S2C operates purely on centroid coordinates and combines descriptor-space matching, Random Sample Consensus (RANSAC) verification, and Hungarian assignment. Across a synthetic benchmark of 1,262 paired runs spanning 100-1,000 neurons and 8 perturbation conditions plus 1 identity sanity-floor, S2C reached pooled F1 = 98.4% compared to the standard ROI-based matching of 36.0%. To show what this enables, we applied the pipeline to dorsomedial striatum (DMS) imaging during oral fentanyl behavioral-economics self-administration. Here, we show that a conserved population-rewarded lever press response in DMS masks near-complete single-neuron turnover. This representational-drift signature we demonstrated is invisible to the bulk photometry, and resolving it requires the same-cell tracking S2C provides. S2C is distributed as a GUI-driven standalone application for both macOS and Windows, requiring no Python, command line, or virtual environment setup.

PMID 42465513
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PubMedEuropean journal of clinical pharmacology2026-07-17

Precipitants and clinical features of serotonin syndrome: a systematic review with patient-level analysis of published case reports and series.

Blyzniuk Bohdan B, Danukalo Maksym M, Gastaldon Chiara C, Barbui Corrado C et al.

Serotonin syndrome (SS) is a concern for prescribers of serotonergic acting agents and mainly antidepressants, yet the implicated drug combinations and associated outcomes across clinical settings remain incompletely characterized. We performed a systematic review in PubMed/Embase, searching for SS cases in adults from the database's inception until June 2024, and conducted a patient-level and network analysis of drug co-occurrence. The quality of SS diagnoses was assessed using the Hunter Serotonin Toxicity and the Sternbach Criteria. A total of 764 cases were included; 653 (85.6%) and 496 (65.0%) met the Sternbach and the Hunter Criteria, respectively. Patients with SS following suicide attempts were more frequently admitted to intensive care units with higher mortality rates than patients with SS related to regular prescriptions (79.4% vs 35.6% and 18.0% vs 5.1%, respectively, both p < 0.001). Of 645 regular prescription cases, 92.9% were drug combinations (≥ 2 agents). Monotherapy cases were milder and often occurred after initiation of a new antidepressant in younger patients. Drug combinations involved non-antidepressants in 90.7%. Network analysis identified trazodone as the most connected antidepressant, and fentanyl and tramadol as the most connected non-antidepressant nodes. We identified five SS cases following antipsychotic discontinuation while maintaining serotonergic agents. Non-suicidal cases of SS during regular prescription were less serious than SS cases associated with intentional overdose. The emerging role of non-antidepressant agents (e.g., several opioids and antiparkinsonian drugs) as potential precipitants support tailored interprofessional medication review in poly-medicated subjects.

PMID 42463509
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PubMedAddiction (Abingdon, England)2026-07-17

Real-world comparative effects of slow-release oral morphine vs. methadone on healthcare use for opioid use disorder: A population-based target trial emulation.

Zhou Vivienne Y VY, Fairbairn Nadia N, Lei Jingxin J, Brar Rupinder R et al.

To examine the comparative effects of slow-release oral morphine (SROM) vs. methadone for the treatment of opioid use disorder (OUD) on healthcare use. This retrospective cohort study emulated a target trial using electronic medical record data from Vancouver Coastal Health Authority linked with population-based administrative health data from British Columbia (BC), Canada. Vancouver Coastal Health region in BC, between 1 July 2017 and 30 June 2024, operating under a universal healthcare system, where the majority of illicit opioids are contaminated with fentanyl. OUD patients aged between 18 and 65 years. Intent-to-treat (ITT): receiving a new prescription of SROM or methadone for the treatment of OUD (regardless of treatment initiation or adherence). Per-protocol (PP): initiating and adhering to the prescribed SROM vs methadone (real-world on-treatment exposure). The daily rate of healthcare use-including all-cause and opioid-specific emergency department (ED) visits, all-cause and opioid-specific hospitalization days, all-cause physician encounters/services, OUD-related physician visits, and non-OUD-related primary care physician visits-over 1 year following treatment prescription or initiation was modelled using weighted modified Poisson regression with generalized estimating equations. Cumulative healthcare use at 1 year and corresponding adjusted rate ratios (aRRs) were estimated. We identified 3254 unique individuals [median (Q1-Q3) age 37 (30-46) years, 64.2% male] contributing to 4059 person-trials (eligible treatment episodes) for the ITT analysis (32.6% SROM) and 1992 unique individuals contributing to 2276 person-trials for the PP analysis (27.4% SROM). ITT analysis shows that receiving a SROM vs. methadone prescription was not associated with statistically significant differences in the rates of all-cause [aRR = 1.10, 95% confidence interval (CI) = 0.997-1.20] and opioid-specific ED visits (aRR = 1.00, 95% CI = 0.90-1.13), all-cause (aRR = 0.99, 95% CI = 0.81-1.18) and opioid-specific hospitalization days (aRR = 0.97, 95% CI = 0.78-1.20), all-cause physician encounters/services (aRR = 1.00, 95% CI = 0.94-1.06), OUD-related physician visits (aRR = 0.94, 95% CI = 0.87-1.01) and primary care physician visits (aRR = 1.11, 95% CI = 0.98-1.24). PP analysis also did not observe statistically significant differences across healthcare outcomes among those who initiated and remained on SROM vs. methadone treatment, with aRRs of 1.24 (95% CI = 0.91-1.50), 1.01 (95% CI = 0.67-1.36), 1.06 (95% CI = 0.65-1.58), 0.95 (95% CI = 0.53-1.58), 1.03 (95% CI = 0.90-1.17), 0.97 (95% CI = 0.82-1.14) and 1.06 (95% CI = 0.73-1.46), respectively. This emulated trial on opioid use disorder patients under a universal healthcare setting in Canada did not observe statistically significant differences in risk of healthcare use outcomes between the patients receiving slow-release oral morphine and those receiving methadone following treatment prescription and initiation. This supports slow-release oral morphine as a viable alternative to methadone with similar real-world effectiveness in preventing all-cause and opioid-related acute healthcare needs and the potential to expand treatment options for opioid use disorder without increasing health system burden.

PMID 42464066
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