Table 7: Pediatric Maximum Transmucosal/Transdermal Fentanyl Dosages

Fentanyl Dosage Form Dosage Strengths Maximum Dose
transmucosal lozenge (Actiq®, generic) 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, or 1600 mcg per lozenge 16 years and older: no more than 2 units/lozenges per breakthrough pain episode; no more than 4 lozenge units/day; if more than 4 breakthrough episodes per 24 hours occur once maintenance dose determined, long-acting opioid dose should be re-evaluated
transdermal patch (Duragesic®, generic) 12 mcg/hr, 25 mcg/hr, 37.5 mcg/hr, 50 mcg/hr, 75 mcg/hr, 100 mcg/hr 2 years and older: maximum dose not identified; dosages titrated every 3 days after initial dose, then every 6 days thereafter