Single-dose fentanyl sublingual spray for breakthrough cancer pain

Donald R Taylor Comprehensive Pain Care PC, Marietta, GA, USA Abstract: Breakthrough cancer pain (BTCP) is defined as a transient exacerbation of pain that arises in patients with otherwise controlled persistent pain. BTCP typically has a rapid onset and relatively short duration, but it causes a si...

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Autor principal:	Taylor DR
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Therapeutics. Pharmacology RM1-950
Acceso en línea:	https://doaj.org/article/d9c98384eecd44c29850ed760f67acc5
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spelling	oai:doaj.org-article:d9c98384eecd44c29850ed760f67acc52021-12-02T03:00:34ZSingle-dose fentanyl sublingual spray for breakthrough cancer pain1179-1438https://doaj.org/article/d9c98384eecd44c29850ed760f67acc52013-07-01T00:00:00Zhttp://www.dovepress.com/single-dose-fentanyl-sublingual-spray-for-breakthrough-cancer-pain-a13764https://doaj.org/toc/1179-1438Donald R Taylor Comprehensive Pain Care PC, Marietta, GA, USA Abstract: Breakthrough cancer pain (BTCP) is defined as a transient exacerbation of pain that arises in patients with otherwise controlled persistent pain. BTCP typically has a rapid onset and relatively short duration, but it causes a significant amount of physical and psychological distress for patients. Several rapid-onset fentanyl formulations have been introduced in the USA to replace traditional oral opioids for the treatment of BTCP: a transmucosal lozenge, a sublingual orally disintegrating tablet, a buccal tablet, a buccal soluble film, a pectin nasal spray and, the newest formulation to enter the market, a sublingual spray. This article reviews the six rapid-onset formulations of fentanyl approved in the USA for the management of BTCP with emphasis on describing the published literature on fentanyl sublingual spray. The different fentanyl formulations vary in pharmacokinetic properties and ease of use, but all have a rapid onset and a relatively short duration of analgesia. Fentanyl sublingual spray has demonstrated absorption within 5 minutes of administration, with fentanyl plasma concentrations increasing over the first 30 minutes and remaining elevated for 60–90 minutes in pharmacokinetic studies in healthy subjects. Fentanyl sublingual spray shows linear dose proportionality, and changes in the temperature or acidity of the oral cavity do not alter its pharmacokinetic properties. In patients with BTCP, statistically significant pain relief is measurable at 5 minutes after administration of fentanyl sublingual spray, when compared with placebo, with significant pain relief lasting at least 60 minutes after administration. Adverse events are typical of opioid treatment and are considered mild to moderate in intensity. In summary, fentanyl sublingual spray provides rapid onset of analgesia and is a tolerable and effective treatment for BTCP. Keywords: breakthrough pain, cancer, fentanyl, rapid-onset opioid, sublingual, fentanyl sublingual sprayTaylor DRDove Medical PressarticleTherapeutics. PharmacologyRM1-950ENClinical Pharmacology: Advances and Applications, Vol 2013, Iss Issue 1, Pp 131-141 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Therapeutics. Pharmacology RM1-950
spellingShingle	Therapeutics. Pharmacology RM1-950 Taylor DR Single-dose fentanyl sublingual spray for breakthrough cancer pain
description	Donald R Taylor Comprehensive Pain Care PC, Marietta, GA, USA Abstract: Breakthrough cancer pain (BTCP) is defined as a transient exacerbation of pain that arises in patients with otherwise controlled persistent pain. BTCP typically has a rapid onset and relatively short duration, but it causes a significant amount of physical and psychological distress for patients. Several rapid-onset fentanyl formulations have been introduced in the USA to replace traditional oral opioids for the treatment of BTCP: a transmucosal lozenge, a sublingual orally disintegrating tablet, a buccal tablet, a buccal soluble film, a pectin nasal spray and, the newest formulation to enter the market, a sublingual spray. This article reviews the six rapid-onset formulations of fentanyl approved in the USA for the management of BTCP with emphasis on describing the published literature on fentanyl sublingual spray. The different fentanyl formulations vary in pharmacokinetic properties and ease of use, but all have a rapid onset and a relatively short duration of analgesia. Fentanyl sublingual spray has demonstrated absorption within 5 minutes of administration, with fentanyl plasma concentrations increasing over the first 30 minutes and remaining elevated for 60–90 minutes in pharmacokinetic studies in healthy subjects. Fentanyl sublingual spray shows linear dose proportionality, and changes in the temperature or acidity of the oral cavity do not alter its pharmacokinetic properties. In patients with BTCP, statistically significant pain relief is measurable at 5 minutes after administration of fentanyl sublingual spray, when compared with placebo, with significant pain relief lasting at least 60 minutes after administration. Adverse events are typical of opioid treatment and are considered mild to moderate in intensity. In summary, fentanyl sublingual spray provides rapid onset of analgesia and is a tolerable and effective treatment for BTCP. Keywords: breakthrough pain, cancer, fentanyl, rapid-onset opioid, sublingual, fentanyl sublingual spray
format	article
author	Taylor DR
author_facet	Taylor DR
author_sort	Taylor DR
title	Single-dose fentanyl sublingual spray for breakthrough cancer pain
title_short	Single-dose fentanyl sublingual spray for breakthrough cancer pain
title_full	Single-dose fentanyl sublingual spray for breakthrough cancer pain
title_fullStr	Single-dose fentanyl sublingual spray for breakthrough cancer pain
title_full_unstemmed	Single-dose fentanyl sublingual spray for breakthrough cancer pain
title_sort	single-dose fentanyl sublingual spray for breakthrough cancer pain
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/d9c98384eecd44c29850ed760f67acc5
work_keys_str_mv	AT taylordr singledosefentanylsublingualsprayforbreakthroughcancerpain
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Single-dose fentanyl sublingual spray for breakthrough cancer pain

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