A new opioid that is far more potent than fentanyl and 500 times stronger than morphine is nearing approval by the U.S. Food and Drug Administration (FDA), according to MarketWatch.

The drug, Dsuvia, comes in a single-dose tablet that is preloaded in a plastic applicator that deposits the medication under a patient’s tongue.

The FDA’s Anesthetic and Analgesic Drug Products Advisory Committee recommended Dsuvia for approval. A final decision is expected by November 3. The FDA often follows its advisory committee recommendations.

The chair of the committee, Dr. Raeford Brown, has spoken out against Dsuvia. He said he is concerned about putting another strong opioid on the market. “This drug offers no advance, in my mind, over previously available opioid formulations, but provides great risk of harm to patients and the general public health,” Brown told MarketWatch.