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Title: Acetylfentanyl  
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Subject: Janssen Pharmaceutica, General anesthetics, Kobret, 6β-Naltrexol-d4, 6'-Guanidinonaltrindole
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Systematic (IUPAC) name
Clinical data
Legal status
  • CA: Schedule 1 [1]
  • US: Schedule 1 [2]
Routes of
oral, iv, im, insuflation
CAS Registry Number
ATC code None
PubChem CID:
Synonyms Acetyl fentanyl
Chemical data
Formula C21H26N2O
Molecular mass 322.44 g/mol

Acetylfentanyl (acetyl fentanyl) is an opioid analgesic drug that is an analog of fentanyl. Studies have estimated acetylfentanyl is between five to fifteen times more potent than heroin.[3] Additionally it is reported as being 80 times more potent than morphine, and 15 times less potent than fentanyl.[4] It has never been licensed for medical use and has only been sold illegally as a designer drug. Acetylfentanyl was discovered at the same time as fentanyl itself and had rarely been encountered on the illicit market in the late 1980s, but was never commonly used. However in 2013, Canadian police discovered a group distributing over 3 kilograms and 12,400 pills of Acetylfentanyl equal to 117,400 doses.[5] As a μ-opioid receptor agonist, acetylfentanyl may serve as a direct substitute for heroin or other μ-opioid receptor agonist substances in opioid dependent individuals. Side effects of fentanyl analogs are similar to those of fentanyl itself, which include itching, nausea and potentially serious respiratory depression, which can be life-threatening. Fentanyl analogs have killed hundreds of people throughout Europe and the former Soviet republics since the most recent resurgence in use began in Estonia in the early 2000s, and novel derivatives continue to appear.[6][7][8][9]


The Centers for Disease Control and Prevention (CDC) issued a health alert to report that between March 2013 and May 2013, 14 overdose deaths related to injected acetylfentanyl had occurred among intravenous drug users (ages between 19 and 57 years) in Rhode Island. After confirming five overdoses in one county, including a fatality, Pennsylvania asked coroners and medical examiners across the state to screen for acetylfentanyl. This request led to 50 confirmed fatalities and five non-fatal overdoses statewide in 2013.[10][11] Another 5 deaths were reported in Jefferson Parish, New Orleans,[12] along with three more in North Carolina.[13]

Legal status


It is a Schedule 1 drug.[1] As it is an analog of fentanyl[14] and all fentanyl analogs are Schedule 1.


As of October, 2015 acetylfentanyl is a controlled substance in China.[15]

United States

Acetylfentanyl is a Schedule I controlled substance as of May 2015.[16]

The illegality of the drug has been supported by the charges against individuals for distribution of acetylfentanyl and possession with the intent to distribute acetylfentanyl.[2] The individual was sentenced to 3 years in prison by a federal court.[17]


Acetylfentanyl overdosage has been reported to closely resemble heroin overdosage clinically. Additionally, while naloxone (Narcan) is effective in treating acetylfentanyl overdose, larger than normal doses of the antidote may be required.[3]

Detection in body fluids

Acetylfentanyl may be quantitated in blood, plasma or urine by liquid chromatography-mass spectrometry to confirm a diagnosis of poisoning in hospitalized patients or to provide evidence in a medicolegal death investigation. Postmortem peripheral blood acetylfentanyl concentrations have been in a range of 89–945 μg/L in victims of acute overdosage.[18][19]

See also


  1. ^ a b
  2. ^ a b
  3. ^ a b
  4. ^ P. A. J. Janssen and C. A. M. van der Eycken in Drugs Affecting the Central Nervous System, Vol. 2, A. Burger, Ed., Marcel Dekker, New York, 1968, pp. 51-54.
  5. ^
  6. ^
  7. ^
  8. ^ CDC Issues Alert On Deadly New Designer Drug, Acetyl Fentanyl. David Kroll, Forbes Magazine, 29 August 2013
  9. ^
  10. ^
  11. ^
  12. ^
  13. ^
  14. ^
  15. ^
  16. ^
  17. ^
  18. ^ A.L. Patton, K.A. Seely, S. Pulla et al. Quantitative measurement of acetyl fentanyl and acetyl norfentanyl in human urine by LC-MS/MS. Anal. Chem. 86: 1760–1766, 2014.
  19. ^

Further reading

  • John M. Stogner, The Potential Threat of Acetyl Fentanyl: Legal Issues, Contaminated Heroin, and Acetyl Fentanyl “Disguised” as Other Opioids. Annals of Emergency Medicine, Volume 64, no. 6 : December 2014.
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