Lazanda spray

Generic Name: fentanyl (FEN-ta-nil)
Brand Name: Lazanda

Lazanda spray can be harmful or fatal if taken by children, patients for whom it has not been prescribed, or patients who are not tolerant to narcotic (opioid) pain medicine. Keep Lazanda spray out of the reach of children.

Lazanda spray is only for breakthrough pain caused by cancer in patients 18 years old and older who are already using and are tolerant to around-the-clock narcotic pain medicine. Severe and sometimes fatal breathing problems can occur in patients using Lazanda spray, especially in patients who are not already using other narcotic medicines or patients who are taking certain other medicines. Ask your health care provider if Lazanda spray may interact with other medicines that you take. Do not use Lazanda spray for short-term pain (including headache, dental pain, or migraine) or for pain that occurs after surgery or injuries.

Do NOT take more than the recommended dose or use more often than prescribed. You must wait at least 2 hours after your last dose of Lazanda spray before treating a NEW episode of breakthrough pain with Lazanda spray.

Do not switch between Lazanda spray and other medicines that contain fentanyl without first talking with your doctor. Different types of medicines that contain fentanyl may release different amounts of Lazanda spray into your body. This may cause severe and possibly fatal overdose. Talk with your doctor or pharmacist for more information.


Lazanda spray is used for:

Managing breakthrough pain in cancer patients 18 years of age and older who are already using and are tolerant to around-the-clock narcotic pain medicines.

Lazanda spray is a narcotic (opioid) analgesic. It works in the brain to decrease pain.

Do NOT use Lazanda spray if:

  • you are allergic to any ingredient in Lazanda spray or to any similar medicine (eg, sufentanil)
  • you have not been taking other narcotic pain medicines (eg, morphine, codeine) on a regular schedule
  • you have mild or short-term pain, including pain from injuries, surgery, dental pain, headache, or migraine
  • you are taking sibutramine or sodium oxybate (GHB)
  • you are taking or have taken a monoamine oxidase inhibitor (MAOI) (eg, phenelzine) within the past 14 days

Contact your doctor or health care provider right away if any of these apply to you.

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Before using Lazanda spray:

Some medical conditions may interact with Lazanda spray. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you have a history of mental or mood problems (eg, depression), hallucinations, or suicidal thoughts or actions
  • if you have severe drowsiness; lesions, growths, or increased pressure in the brain; or a recent head injury
  • if you have lung or breathing problems (eg, asthma, slow or difficult breathing, chronic obstructive pulmonary disease [COPD]), urinary blockage, heart problems (eg, slow or irregular heartbeat, ventricle problems), liver or kidney disease, inflammation in the mouth, an enlarged prostate or benign prostatic hypertrophy (BPH), stomach or bowel problems (eg, constipation, inflammatory bowel disease, pseudomembranous colitis, stomach pain), an underactive thyroid, low blood pressure, or seizures
  • if you or a family member has a history of alcohol, narcotic, or other substance abuse or dependence
  • if you have been very ill, have a fever, have poor health or nutrition, or have had a recent surgery (eg, stomach or bowel surgery)
  • if you stop taking your around-the-clock narcotic pain medicine

Some MEDICINES MAY INTERACT with Lazanda spray. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Amiodarone, antihistamines (eg, diphenhydramine), aprepitant, azole antifungals (eg, ketoconazole), benzodiazepines (eg, diazepam), calcium channel blockers (eg, diltiazem, verapamil), cimetidine, macrolides (eg, erythromycin, clarithromycin), MAOIs (eg, phenelzine), nefazodone, other opioid medicines (eg, oxycodone), phenothiazines (eg, chlorpromazine), protease inhibitors (eg, ritonavir), skeletal muscle relaxants (eg, cyclobenzaprine), sleep medicines (eg, zolpidem), sodium oxybate (GHB), or telithromycin because they may increase the risk of Lazanda spray's side effects, including serious breathing problems, severe light-headedness or dizziness, or severe drowsiness
  • Serotonin reuptake inhibitors (eg, fluoxetine) or sibutramine because a severe reaction that may include fever, rigid muscles, blood pressure changes, mental changes, confusion, irritability, agitation, delirium, and coma may occur
  • Mixed agonist/antagonist analgesics (eg, pentazocine, buprenorphine, butorphanol), nalmefene, naloxone, or naltrexone because they may decrease Lazanda spray's effectiveness and withdrawal symptoms may occur
  • Barbiturates (eg, phenobarbital), carbamazepine, corticosteroids (eg, prednisone), efavirenz, modafinil, certain nasal decongestants (eg, oxymetazoline), nevirapine, oxcarbazepine, phenytoin, pioglitazone, rifamycins (eg, rifampin), St. John's wort, or troglitazone because they may decrease Lazanda spray's effectiveness

This may not be a complete list of all interactions that may occur. Ask your health care provider if Lazanda spray may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Lazanda spray:

Use Lazanda spray as directed by your doctor. Check the label on the medicine for exact dosing instructions.

  • Lazanda spray comes with an extra patient information sheet called a Medication Guide. Read it carefully. Read it again each time you get Lazanda spray refilled.
  • When you first start to use Lazanda spray, your doctor may adjust your dose to find the dose that controls your pain the best. Be sure to follow the directions for using Lazanda spray provided by your doctor. Do NOT change your dose of Lazanda spray without checking with your doctor.
  • Do not remove Lazanda spray from the child-resistant container until you are ready to use it. Replace the bottle in the child-resistant container between doses of Lazanda spray. Keep Lazanda spray, both unopened and opened bottles, in the child-resistant container and out of the reach of children at all times.
  • Before you use a new bottle for the first time, you will need to prime it. Prime the bottle according to the directions in the medication guide. Contact your pharmacist if you are unsure how to prime the bottle.
  • To be sure that Lazanda spray is ready to be used, be sure that you see either a green bar or a number in the counting window.
  • If you have a runny nose, blow your nose before using Lazanda spray.
  • To use a dose of Lazanda spray, remove the protective cap from the tip and sit up with your head upright. Hold the bottle with your thumb on the bottom, and your first and middle fingers on the finger grips. Place the tip of the spray container into the nose and point it toward the bridge of your nose. Using a finger from your other hand, press against the opposite nostril to close it off. Press down on the finger grips until you hear a click. Breathe in gently through your nose and out through your mouth 1 time after spraying. Do not sniff after spraying Lazanda spray in your nose.
  • If your dose is equal to 2 sprays of Lazanda spray, repeat these steps in the other nostril. Do NOT use more than 1 dose of Lazanda spray per episode of breakthrough pain.
  • Stay seated for at least 1 minute after using Lazanda spray. Avoid blowing your nose for at least 30 minutes after each spray.
  • After you are done using your dose, replace the protective cap on the tip of the bottle and return the bottle to the child-resistant container.
  • After each spray, the number in the counting window will increase by 1. When you see a red number 8 in the counting window, the bottle is finished. You may still see medicine in the bottle but there is not enough for a full dose.
  • If your breakthrough pain does NOT get better within 30 minutes after your dose, follow your doctor's directions about taking other medicine to manage your pain. If your breakthrough pain does not get better, contact your doctor.
  • Wait at least 2 hours after your last dose of Lazanda spray before treating a NEW episode of breakthrough pain. If you have more than 4 episodes of breakthrough pain per day, tell your doctor.
  • Dispose of Lazanda spray if you have used 8 sprays from a bottle, if it has been 5 days since you last used it, or if it has been 14 days since you primed it. If Lazanda spray is no longer needed, dispose of it as soon as possible. Ask your doctor or pharmacist how to dispose of Lazanda spray properly.
  • Check with your doctor before including grapefruit or grapefruit juice in your diet while you use Lazanda spray.
  • Lazanda spray is usually used as needed. If you forget to use a dose of Lazanda spray and you still have pain, use it when you remember and as directed by your doctor. Do not take 2 doses at once.

Ask your health care provider any questions you may have about how to use Lazanda spray.

Important safety information:

  • Lazanda spray may cause drowsiness or dizziness. These effects may be worse if you take it with alcohol or certain medicines. Use Lazanda spray with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.
  • Do not drink alcohol while you are using Lazanda spray.
  • Check with your doctor before you use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Lazanda spray; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.
  • Lazanda spray may cause dizziness, light-headedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.
  • Constipation is a common side effect of Lazanda spray. Talk with your doctor about using laxatives or stool softeners while you use Lazanda spray to prevent or treat constipation. It is also important to maintain a diet adequate in fiber, drink plenty of water, and exercise to prevent constipation.
  • Do NOT take more than the recommended dose, use more often than prescribed, or suddenly stop using Lazanda spray without checking with your doctor.
  • Tell your doctor or dentist that you use Lazanda spray before you receive any medical or dental care, emergency care, or surgery.
  • Contact your doctor if your pain is not relieved or if it worsens after you use Lazanda spray. Contact your doctor if your usual dose stops providing pain relief. Be sure to tell your doctor or health care provider how your pain is responding to Lazanda spray so that your dose can be adjusted if needed.
  • Do not switch between Lazanda spray and other medicines that contain fentanyl without first talking to your doctor. Different types of medicines that contain fentanyl may release different amounts of Lazanda spray into your body. This may cause severe and possibly fatal overdose. Discuss any questions or concerns with your doctor or pharmacist.
  • Use Lazanda spray with caution in the ELDERLY; they may be more sensitive to its effects, especially breathing problems.
  • Lazanda spray can be harmful, even fatal, if used in CHILDREN. Keep Lazanda spray out of the reach of children.
  • PREGNANCY and BREAST-FEEDING: Lazanda spray may cause harm to the fetus. If you think you may be pregnant, contact your doctor. You will need to discuss the benefits and risks of using Lazanda spray while you are pregnant. Lazanda spray is found in breast milk. Do not breast-feed while using Lazanda spray.

When used for long periods of time or at high doses, Lazanda spray may not work as well and may require higher doses to obtain the same effect as when first taken. This is known as TOLERANCE. Talk with your doctor if Lazanda spray stops working well. Do not take more than prescribed.

When used for long periods of time or at high doses, some people develop a need to continue taking Lazanda spray. This is known as DEPENDENCE or "addiction."

If you suddenly stop taking Lazanda spray, you may experience WITHDRAWAL symptoms, including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing, or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of Lazanda spray:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; headache; nasal discomfort; nausea; stuffy or runny nose; taste changes; vomiting.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, throat, or tongue); chest pain; confusion; coughing up blood; difficult or painful urination; fainting; fast, slow, or irregular heartbeat; fever; hallucinations; mood or mental changes (eg, depression); seizures; severe drowsiness; severe or persistent dizziness or headache; severe or persistent stomach pain; shortness of breath; slowed, shallow, or trouble breathing; unusual weakness or tiredness.

If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include loss of consciousness; muscle rigidity; pinpoint pupils; severe drowsiness or dizziness; slow or shallow breathing; very slow or weak heartbeat.

Proper storage of Lazanda spray:

Store Lazanda spray below 77 degrees F (25 degrees C). Store in the original package, away from heat, moisture, and light. Do not store in the bathroom. Do not freeze. Keep Lazanda spray out of the reach of children and away from pets.

General information:

  • If you have any questions about Lazanda spray, please talk with your doctor, pharmacist, or other health care provider.
  • Lazanda spray is to be used only by the patient for whom it is prescribed. Do not share it with other people.
  • If your symptoms do not improve or if they become worse, check with your doctor.
  • Check with your pharmacist about how to dispose of unused medicine.

This information should not be used to decide whether or not to take Lazanda spray or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about Lazanda spray. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to Lazanda spray. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using Lazanda spray.

Issue Date: September 3, 2014
Database Edition 14.3.1.003
Copyright © 2014 Wolters Kluwer Health, Inc.

Disclaimer: This information should not be used to decide whether or not to take this medicine or any other medicine. Only your health care provider has the knowledge and training to decide which medicines are right for you. This information does not endorse any medicine as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this medicine. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this medicine. This information is not specific medical advice and does not replace information you receive from your health care provider. You must talk with your healthcare provider for complete information about the risks and benefits of using this medicine.

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