<p>Opioid analgesics impair the mental and/or physical ability required for the performance of potentially dangerous tasks (e.g. driving a car or operating machinery). Patients taking Fentanyl should be warned of these dangers and should be counseled accordingly. The use of concomitant CNS active drugs requires special patient care and observation.<br />
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<strong>Chronic pulmonary disease</strong>: Fentanyl should be titrated with caution in patients with chronic obstructive pulmonary disease or pre-existing medical conditions predisposing them to respiratory depression.&nbsp;<br />
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<strong>Head injuries and increased intracranial pressure</strong>: Opioids may obscure the clinical course of a patient with a head injury and should be used only if clinically warranted.<br />
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<strong>Cardiac disease</strong>: Intravenous Fentanyl may produce bradycardia. Therefore, Fentanyl should be used with caution in patients with bradyarrhythmias.<br />
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<strong>Hepatic or renal disease</strong>: Fentanyl should be used with caution because of the hepatic metabolism and renal excretion of Fentanyl.</p>