Fentanyl for the Treatment of Tumor-Related Breakthrough Pain

Abstract

SUMMARYBackground: Breakthrough cancer pain (BTCP) is common among cancer patients and markedly lowers their quality of life. The treatment for BTCP episodes that is recommended in current guidelines involves extended-release formulations in combination with rapid-onset and shortacting opioids. In the past few years, several new preparations of fentanyl, an opioid with a very rapid onset, have been approved for this indication. Treating physicians need to be aware of the clinical differences between the newer fentanyl preparations and immediate-release opioids.

Lack of Precision in Colloquial Language Results in Incorrect Therapeutic Recommendation

“…We actually did discuss the risk of addiction in our article (1). The scarce evidence should not be misinterpreted as a low risk.…”

“…By contrast, genuine breakthrough pain-described in palliative medicine as an independent type-is rare. The authors define breakthrough pain correctly as a sudden-onset, transient exacerbation of generally wellcontrolled background pain (1). Additionally, we wish to mention that the frequency of genuine breakthrough pain cannot be influenced by increasing patients' opiate-based medication.…”

Fentanilo: una molécula y múltiples formulaciones galénicas de trascendencia clínica en el tratamiento del dolor irruptivo oncológico

“…Sin embargo, esta opinión puede considerarse una excepción, ya que la mayoría de los autores señalan que el inicio y la duración de la acción de los opiáceos orales no son las adecuadas para el tratamiento del dolor irruptivo. Además, es opinión casi generalizada que los opioides de acción rápida, entre los que destaca el fentanilo por ser el opioide más empleado en este cuadro (4), son los fármacos de elección para el tratamiento del dolor irruptivo (20)(21)(22)(23)(24)(25)(26). Asimismo, el metanálisis realizado por Jandhyala y cols.…”

Determination of Fentanyl in Injection Solution Exposed to Improper Storage Conditions

“…FDA-approved indications of fentanyl also include postoperative pain and breakthrough cancer pain (BORNEMANN-CIMENTI, 2013;MICROMEDEX, 2017). Fentanyl readily permeate the blood-brain barrier and have an intrinsic action at the opioid receptor, with rapid onset and short duration (BORNEMANN-CIMENTI, 2013). …”