Commonly available fentanyl transmucosal preparations for breakthrough pain in opioid-tolerant adults
|Fentanyl transmucosal preparation ||Brand name |
|Starting dose in an opioid-tolerant adult* ||Serum half-life |
|Duration of analgesic effect |
|Buccal tablet ||Fentora ||100 mcg ||13.3 ||1 to 2 |
|Oral lozenge ||Actiq ||200 mcg ||7.6 ||2 |
|Nasal spray ||Lazanda ||100 mcg ||15 to 25 ||≥1 |
|Sublingual spray ||Subsys ||100 mcg ||5 to 12 ||≥1 |
|Sublingual tablet ||Abstral ||100 mcg ||11.5 to 25 ||1 |
An oral, immediate-release (IR) preparation (eg, oxycodone IR) is generally used for managing brief episodes of breakthrough pain not attributed to inadequate doses of scheduled long-acting opioids. A transmucosal fentanyl preparation can provide an alternative to oral IR opioid preparations in patients who may benefit from a more rapid onset of analgesia, ie, 5 to 15 minutes for transmucosal route compared with 10 to 15 minutes typically for oral IR opioids.
Courtesy of Kathleen Broglio, DNP, MN, ANP-BC, ACHPN and Russell K Portenoy, MD.
Additional data from:
- National Comprehensive Cancer Network. Adult Cancer Pain, Version 2.2016.
- Lexicomp Online. Copyright © 1978-2023 Lexicomp, Inc. All Rights Reserved.
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