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Fentanyl N-oxide is formed by your liver -- a typical metabolic activity. Your body responds to foreign substances by "placing an oxygen or hydroxyl group in the 4 position". This is only a generalization, but quite useful as a rule of thumb. Drugs which "block" the 4 position, for example Shulgin's DOB (4-bromo-2,5-dimethoxyamphetamine) is two orders of magnitude more active than similar structures, and removing the bromine (from the 4 position) makes the compound inactive!

Forensic geeks can mimic metabolism by shining uv lights on chemicals, heating them, subjecting them to stress, calling them mean names... In vitro, fentanyl is quickly oxidized by hydrogen peroxide of suitable strength, and probably other oxidizing reagents.

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Q: How is Fentanyl n-oxide formed?
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