How does Dsuvia (sufentanil) work?

Dsuvia (sufentanil) is an [opioid](https://www.goodrx.com/classes/opioids). It works by attaching to opioid receptors in your brain, which helps block your pain.

What is the dose of Dsuvia (sufentanil) and how is it given?

Dsuvia (sufentanil) must be given [under the supervision](https://www.fda.gov/drugs/drug-safety-and-availability/fda-issues-warning-acelrx-making-false-and-misleading-claims-about-risks-and-benefits-dsuvia) of a healthcare provider who is trained to properly give it, usually in the hospital, emergency department, or surgery center. Don't touch the medication with your hands - your provider will wear gloves and place the medication directly in your mouth. The typical dose is 1 Dsuvia (sufentanil) tablet (30 mcg) dissolved under your tongue, no sooner than every 1 hour, as needed for severe pain. Don't chew or swallow the tablet, since this can cause the medication to not work as well. Wait 10 minutes before eating, drinking, or talking after each dose. The maximum dose is 12 tablets (360 mcg) in a 24-hour period. You shouldn't use Dsuvia (sufentanil) for more than 72 hours and must stop this medication when you leave the medical facility.

Can I take Dsuvia (sufentanil) at home?

No, Dsuvia (sufentanil) isn't something you can pick up at the pharmacy and take at home. This medication can cause a very serious side effect called respiratory depression, where your breathing stops or becomes dangerously slow. This is also dangerous for other people who might accidentally come into contact with Dsuvia (sufentanil) without being aware of it. Because of possible serious breathing problems, Dsuvia (sufentanil) is only available under a special [Risk Evaluation and Mitigation Strategy (REMS) program](http://www.DSUVIAREMS.com) and can only be given by a healthcare provider to people in a hospital or surgical center. You must stop this medication when you leave the medical facility.

Dsuvia

Q: What is Dsuvia (sufentanil) used for?

Dsuvia (sufentanil) is used short-term to treat adults with severe pain. It's typically only used in the hospital or surgical center and it's reserved for people either can't use or whose pain isn't relieved by [non-opioid pain medications](https://www.goodrx.com/conditions/pain/non-opioid-options-pain-relief-how-to-choose).

Q: Why is Dsuvia (sufentanil) a controlled medication?

Dsuvia (sufentanil) is a controlled (Schedule II) medication because it has a risk of addiction, abuse, and dependence. __Abuse__ is when a medication is used for non-medical reasons to bring out desirable physical or emotional effects. It's characterized by poor or no control of medication use, irresistible urge to use the medication, continued use despite it being harmful, or craving the medication. For example, people who weren't prescribed Dsuvia (sufentanil) might abuse it because it can bring about euphoria (extreme happiness). __Dependence__ is when you rely on a medication to function normally and experience [withdrawal symptoms](https://www.merckmanuals.com/home/special-subjects/recreational-drugs-and-intoxicants/opioids) if you stop taking it (e.g., fever, chills, muscle twitching, anxiety, high blood pressure and heart rate, nausea, vomiting, diarrhea). Dependence is usually avoided by only taking the medication as prescribed and slowly lowering the dose before completely stopping the medication, as instructed.

sufentanil

Used for Pain

Dsuvia (sufentanil) is a opioid (pain) medication approved by the FDA in 2018 to treat severe pain in people who are in the hospital. It's a tablet that's given under the tongue by a healthcare provider, no sooner than every 1 hour, for a maximum of 12 tablets daily. It can put you at risk for very serious breathing problems, so you must only take it as directed and under the supervision of your provider. Dsuvia (sufentanil) is brand only so it might be expensive.

Reviewed by:

Robert Chad Hakim, PharmD, BCCCP

Kristianne Hannemann, PharmD

Last reviewed on June 29, 2022

Dsuvia (sufentanil) is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.

What is Dsuvia (sufentanil)?

What is Dsuvia (sufentanil) used for?

Pain

Drug facts

Common Brands	Dsuvia
Drug Class	Opioid
Controlled Substance Classification	Schedule II
Generic Status	No lower-cost generic available
Availability	Prescription only

Common Brands

Dsuvia

Drug Class

Opioid

Controlled Substance Classification

Schedule II

Generic Status

No lower-cost generic available

Availability

Prescription only

Risks and warnings for Dsuvia (sufentanil)

Dsuvia (sufentanil) can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

Potentially life-threatening slowed breathing (respiratory depression)

Risk factors: Taking medications that can cause slow breathing | History of substance abuse | Drinking alcohol | Medical conditions that cause breathing problems (e.g., COPD, asthma) | People age 65 and older | Low body weight | Debilitated people

Black Box Warning Dsuvia (sufentanil) can cause life-threatening, irregular, or slowed breathing. Your risk if higher if you're taking other medications that can cause slowed breathing (e.g., benzodiazepines, opioids, muscle relaxants, sleeping medicaitons, sedatives) or drink alcohol. Tell your provider about all the medications you're taking before starting Dsuvia (sufentanil). Respiratory depression can happen at any time, even at recommended doses. This can cause you to stop breathing and can even lead to death, so it's important to recognize signs of breathing problems and treat them right away. If you experience shortness of breath, slow or shallow breathing, or bluish-colored lips, fingers, or toes, get medical help right away.

Dsuvia Risk Evaluation and Mitigation Strategy (REMS)

Black Box Warning Because of the serious risk of respiratory depression if anyone is accidentally exposed to Dsuvia (sufentanil), it's only available through a drug safety program called the Dsuvia REMS. All hospitals or facilities that can give Dsuvia (sufentanil) must be registered with the REMS program. This is to make sure the medication is given under the safest conditions possible for you.

Drug interactions

Black Box Warning Make sure to tell your provider about all of the medications you're taking before starting Dsuvia (sufentanil). Additionally, don't start or stop any medications without talking to your provider first. Dsuvia (sufentanil) interacts with many medications. Some medications cause Dsuvia (sufentanil)'s levels in your body to go up while others cause it to go down. Some of these medications might need to have their dosages adjusted while others might need to be stopped completely. This is to prevent you from having severe toxic effects from Dsuvia (sufentanil), which can be life-threatening. Some examples include, but not limited to, erythromycin, ketoconazole, ritonavir (Norvir), rifampin (Rifadin), carbamazepine (Tegretol), and phenytoin (Dilantin).

Serotonin syndrome

Risk factors: Taking monoamine oxidase inhibitors (MAOI) together or within 14 days before starting Dsuvia (sufentanil) | Taking other medications that raise serotonin levels in your brain

Serotonin syndrome is a rare but potentially life-threatening condition where there's too much serotonin in your brain. Serotonin is one of the chemicals in your brain responsible for your mood. Your risk for serotonin syndrome goes up if you use Dsuvia (sufentanil) with other medications that affect serotonin levels, such as SSRIs, SNRIs, MAOIs, lithium, and triptans. Symptoms of serotonin syndrome include fast heart rate, sweating, muscle stiffness or spasms, fever, and confusion. Get medical help right away if you have any of these symptoms.

Low adrenal hormone levels

Risk factors: Taking Dsuvia (sufentanil) for longer than one month

Opioids like Dsuvia (sufentanil) can cause your adrenal hormone levels to drop. This is more likely to happen after taking opioids for longer than one month. Symptoms include nausea, vomiting, loss of appetite, tiredness, dizziness, and weakness. Let your provider know right away if you experience these symptoms so your hormone levels can be measured.

Severely low blood pressure and low heart rate

Risk factors: Low blood volume | Taking Dsuvia (sufentanil) with medications that are nervous system depressants (e.g., certain antipsychotics or general anesthesia)

Dsuvia (sufentanil) can cause severely low blood pressure and low heart rate. Your blood pressure and heart rate will likely be monitored while you're taking Dsuvia (sufentanil). Let your provider know if you feel lightheaded, dizzy, fatigue, chest pain, or feeling like you're going to faint.

High pressure in the brain

Risk factors: History of high pressure in the brain | Brain tumors | Head injuries

Dsuvia (sufentanil) can raise the pressure in your brain as a result of lowering your breathing rate. Your breathing rate and level of consciousness will be monitored.

Risk in people with stomach problems

Dsuvia (sufentanil) can cause problems with your stomach. Specifically, it can cause a spasm in one of your muscular valves and raise your risk for inflammation of the pancreas. Dsuvia (sufentanil) shouldn't be used in people with a blockage in their gut. Let your provider know if you experience severe constipation while taking this medication.

Seizures

Risk factors: History of seizures

Dsuvia (sufentanil) can raise the risk for seizures in people with a history of seizures or medical conditions that cause seizures.

Common questions about Dsuvia

Dsuvia is used short-term to treat adults with severe pain. It's typically only used in the hospital or surgical center and it's reserved for people either can't use or whose pain isn't relieved by non-opioid pain medications.

Dsuvia is an opioid. It works by attaching to opioid receptors in your brain, which helps block your pain.

Dsuvia must be given under the supervision of a healthcare provider who is trained to properly give it, usually in the hospital, emergency department, or surgery center. Don't touch the medication with your hands - your provider will wear gloves and place the medication directly in your mouth. The typical dose is 1 Dsuvia tablet (30 mcg) dissolved under your tongue, no sooner than every 1 hour, as needed for severe pain. Don't chew or swallow the tablet, since this can cause the medication to not work as well. Wait 10 minutes before eating, drinking, or talking after each dose. The maximum dose is 12 tablets (360 mcg) in a 24-hour period. You shouldn't use Dsuvia for more than 72 hours and must stop this medication when you leave the medical facility.

No, Dsuvia isn't something you can pick up at the pharmacy and take at home. This medication can cause a very serious side effect called respiratory depression, where your breathing stops or becomes dangerously slow. This is also dangerous for other people who might accidentally come into contact with Dsuvia without being aware of it. Because of possible serious breathing problems, Dsuvia is only available under a special Risk Evaluation and Mitigation Strategy (REMS) program and can only be given by a healthcare provider to people in a hospital or surgical center. You must stop this medication when you leave the medical facility.

Dsuvia is a controlled (Schedule II) medication because it has a risk of addiction, abuse, and dependence. Abuse is when a medication is used for non-medical reasons to bring out desirable physical or emotional effects. It's characterized by poor or no control of medication use, irresistible urge to use the medication, continued use despite it being harmful, or craving the medication. For example, people who weren't prescribed Dsuvia might abuse it because it can bring about euphoria (extreme happiness). Dependence is when you rely on a medication to function normally and experience withdrawal symptoms if you stop taking it (e.g., fever, chills, muscle twitching, anxiety, high blood pressure and heart rate, nausea, vomiting, diarrhea). Dependence is usually avoided by only taking the medication as prescribed and slowly lowering the dose before completely stopping the medication, as instructed.

The most common side effects are nausea and headache. Other possible side effects include vomiting, dizziness, and low blood pressure.

Dsuvia

Dsuvia (sufentanil) is a controlled substance, which means that it's more likely to be misused or cause dependence. There are federal and state laws that limit the amount of medication that can be prescribed or dispensed within a certain period of time.