The Medical Letter on Drugs and Therapeutics
Fentanyl Buccal Tablet (Fentora) for Breakthrough Pain
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The FDA has approved a transmucosal tablet formulation of fentanyl citrate (Fentora – Cephalon) for management of breakthrough pain in opioid-tolerant patients with cancer. An oral transmucosal fentanyl lozenge on a stick (Actiq, and others) is also available for this indication, and is widely used off-label for chronic, non-cancer pain as well.

BREAKTHROUGH PAIN — Breakthrough pain, a sudden, transitory exacerbation of persistent pain that is otherwise adequately controlled, is common in patients with cancer. Episodes may occur several times a day and typically last 30-60 minutes. Breakthrough pain is usually managed with short-acting oral opioids, but in patients with unpredictable breakthrough pain, the onset of analgesia with these drugs (typically within 30-60 minutes) may occur too late.

PHARMACOLOGY — Fentanyl is about 75-100 times more potent than morphine. The new ... more      

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Title: Fentanyl Buccal Tablet (Fentora) for Breakthrough Pain
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