Use of Inhaled Vapour (Penthrox™) for Painful Procedures
Everyone experiences pain differently. For some medical procedures, over-the-counter pain relief may not be enough. Penthrox™ is one option that may help. Talk to your provider about what’s right for you.
- Can be used by healthy adults between the ages of 18 and 65
- Can be self-administered
- Commonly called the “green whistle”
- Pain relief typically starts within five minutes. Continuous use provides relief for 25-30 minutes, while intermittent use may last up to 60 minutes.
- PenthroxTM can be used with acetaminophen (TylenolTM).
What is PenthroxTM?
- PenthroxTM (generic name is methoxyflurane) is an inhaled vapour medication used for short-term pain relief during medical procedures.
- It is commonly called the “green whistle” due to the shape and color of the handheld inhaler.
- It is self-administered; you breathe in and out through the device after receiving instructions on how to use it.
- Pain relief typically starts within five minutes. Continuous use provides relief for 25-30 minutes, while intermittent use may last up to 60 minutes.
- PenthroxTM can be used with acetaminophen (TylenolTM).
Who can use it?
- Healthy adults between the ages of 18 and 65.
Do not use Penthrox if
- You have trouble breathing or feel unwell
- You or family member had anesthesia reaction (e.g., malignant hyperthermia)
- You have kidney/liver disease
- You are pregnant or breastfeeding
- You take narcotics, sedatives, muscle relaxants, antihistamines, or certain antibiotics.
- You drank alcohol recently.
- You used Penthrox™ in the last 48 hours or multiple times in 3 months
- You had a negative experience with Penthrox™ before
Alternate Formats
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Is it safe?
- Approved in Australia & New Zealand since the 1970s, Canada since 2022
- Used for procedures like IUD insertions and emergency care
- 5.5M+ doses worldwide, very low serious side effects
- Safe & effective when used as directed
Side effects
- Dizziness
- Drowsiness
- feeling sleepy
- nausea
- headache
- mood changes, or trouble with memory or coordination
- Liver or kidney damage are rare, however, too many doses of PenthroxTM over a short period of time carries a risk
If You Choose PenthroxTM
- Fill prescription & store it at room temperature
- Arrange a ride (you may drive, but confirm with provider)
- Bring inhaler & medication in original packaging
- Avoid ibuprofen (AdvilTM) or naproxen (AleveTM) the same day (resume next day)
How to Use the Green Whistle
- Vital checked before starting
- Provider prepares inhaler & guides you
- Inhale & exhale through inhaler (charcoal filter protects others)
- Relief starts after 6-12 breaths
- Continue as needed during procedure
- You’re in control - stop anytime if unwell
After Your Procedure
- Inhaler sealed & disposed of by provider
- Vital signs checked
- Stay 15-30 mins for monitoring
- No driving or operating machinery until cleared
- Pain relief (e.g., acetaminophen) allowed after leaving
- Track PenthroxTM use & inform future clinicians