TITLE

Transdermal Fentanyl: An Updated Review of its Pharmacological Properties and Therapeutic Efficacy in Chronic Cancer Pain Control

AUTHOR(S)
Muijsers, R.B.R.; Wagstaff, A.J.
PUB. DATE
December 2001
SOURCE
Drugs;Dec2001, Vol. 61 Issue 15, p2289
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Fentanyl is a synthetic opioid agonist which interacts primarily with the µ-opioid receptor. The low molecular weight, high potency and lipid solubility of fentanyl make it suitable for delivery by the transdermal therapeutic system. These patches are designed to deliver fentanyl at a constant rate (25, 50, 75 and 100 µg/h), and require replacement every 3 days. Data from randomised, nonblind trials suggest that transdermal fentanyl is as effective as sustained-release oral morphine in the treatment of chronic cancer pain, as reported by patients using visual and numerical analogue scales as well as verbal description scales. No obvious differences in health-related quality of life were found in patients with chronic cancer pain when comparing transdermal fentanyl with sustained-release oral morphine. Nevertheless, significantly more patients expressed a preference for transdermal fentanyl than for sustained-release oral morphine after a randomised, nonblind, crossover trial. Because of the formation of a fentanyl depot in the skin tissue, serum fentanyl concentrations increase gradually following initial application, generally levelling off between 12 and 24 hours. Thereafter, they remain relatively constant, with some fluctuation, for the remainder of the 72-hour application period. Once achieved, steady-state plasma fentanyl concentrations can be maintained for as long as the patches are renewed. The most frequently observed adverse events during transdermal fentanyl administration (as with other opioid agonists) included vomiting, nausea and constipation. Data from a nonblind, randomised trials suggest that constipation occurs less frequently in patients receiving transdermal fentanyl than in those given sustained-release oral morphine. The most serious adverse event reported in US premarketing trials was hypoventilation, which occurred with an incidence of approximately 2%. Adverse reactions related to skin and appendages (i.e. rash and application site reactions - erythema, papules, itching and oedema) were reported in 153 patients with cancer at a frequency between 1 and 3%. Conclusion: Transdermal fentanyl is a useful opioid-agonist for the treatment of moderate to severe chronic cancer pain. The advantages of transdermal fentanyl include ease of administration and the 3-day application interval. These factors coupled with a lower incidence of constipation are likely to contribute to the reported patient preference of transdermal fentanyl over sustained-release oral morphine.
ACCESSION #
5692967

 

Related Articles

  • Sublingual fentanyl citrate for cancer-related breakthrough pain: a pilot study. Zeppetella, G. // Palliative Medicine;Jul2001, Vol. 15 Issue 4, p323 

    The effects of sublingual fentanyl citrate (SLFC) were assessed in 11 hospice inpatients with cancer-related breakthrough pain. Patients were asked to rate their pain, using a visual analogue scale, before SLFC, then after 3, 5, 10, 15, 30, 45 and 60 min. Six patients (55%) had reductions in...

  • Transdermal fentanyl for the management of cancer pain: a survey of 1005 patients. Radbruch, L.; Sabatowski, R.; Petzke, F.; Brunsch-Radbruch, A.; Grond, S.; Lehmann, K.A. // Palliative Medicine;Jul2001, Vol. 15 Issue 4, p309 

    Transdermal fentanyl was released in Germany in 1995. From October 1996 to February 1998 transdermal treatment was documented for 1005 patients (506 men and 499 women with a mean age of 60 years, range 20-92 years) with chronic pain in an open survey including 290 physicians from hospitals and...

  • A successful study comparing the recently developed oral transmucosal fentanyl citrate (OTFC) with immediate release opioids for cancer breakthrough pain. Nugent, M; Hanks, G; Bush, M // Palliative Medicine;May2000, Vol. 14 Issue 3, p229 

    Evaluates the use of oral transmucosal fentanyl citrate (OTFC) for cancer breakthrough pain in Great Britain. Comparison with immediate release opioids; Definition of breakthrough pain; Safety and effectiveness of OTFC.

  • Spray improved pain management in cancer patients.  // Hem/Onc Today;5/25/2013, Vol. 14 Issue 10, p56 

    The article discusses the findings of a randomized study which revealed the therapeutic use of fentanyl sublingual spray in improving a number of pain and adverse event categories in a cohort of patients with several types of cancer.

  • Breakthrough Cancer Pain: Epidemiology, Characteristics and Management. Fine, P.G. // CNS Drugs;2000, Vol. 13 Issue 5, p313 

    Breakthrough pain is the relatively new term applied to describe acute episodes of severe pain superimposed upon a background of otherwise well controlled chronic pain. Surveys of patients with cancer who have pain suggest that breakthrough pain is very common, affecting the majority of patients...

  • Safety and efficacy of fentanyl administered by patient controlled analgesia in children with cancer pain. A. Ruggiero; G. Barone; L. Liotti; A. Chiaretti; I. Lazzareschi; R. Riccardi // Supportive Care in Cancer;May2007, Vol. 15 Issue 5, p569 

    Abstract Background  Pain is the most common discomfort experienced by children with cancer and occurs in almost 89% of patients in an advanced stage of the disease. It is most often not adequately treated because of inexperience and unfounded fears of analgesic treatment. In adults,...

  • An effective way to manage breakthrough pain. Scholz, Mary // RN;May99, Vol. 62 Issue 5, p102 

    Replies to an inquiry about the management of pain in a patient with metastatic prostate cancer. Use of fentanyl to help control acute flare-ups of cancer pain; Precautions in administering the drug.

  • Onsolis to treat cancer pain.  // Monthly Prescribing Reference;Nov2009, Vol. 25 Issue 11, pA21 

    The article reports that the fentanyl buccal soluble film, Onsolin from Meda AB, is available for the management of pain in cancer patients aged 18 or above and who are tolerant to opiod therapy.

  • Fentanyl.  // Reactions Weekly;Jul2014, Vol. 1509 Issue 1, p17 

    The article presents a case study of a patient who experienced vomiting which resulted in death after being treated with fentanyl pectin nasal spray for cancer pain.

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics