Date - 27 September 2004

Source- Drugs in Context 2004; 1C(4): Fentanyl - Chronic pain p141

Author - Dr Eleanor Bull

The opioid analgesic, fentanyl, is indicated for the relief of chronic cancer as well as non-cancer-related pain, and is available as intravenous, lozenge and transdermal formulations. The transdermal route of administration allows the cutaneous build-up of fentanyl and thus avoids the complications of first-pass metabolism and reduces the frequency of dosing. Patients apply a transdermal patch once every 72 hours and following appropriate dose titration, experience continuous analgesia over this period. Clinical studies comparing transdermal fentanyl with oral morphine for the relief of cancer pain and pain attributable to chronic back conditions and osteoarthritis, have shown that fentanyl is associated with at least the same degree of pain relief and a significantly lower incidence of side-effects than reported with oral morphine, specifically constipation. Care should be taken to avoid the toxicity associated with the cutaneous accumulation of fentanyl following treatment discontinuation. Patients. quality of life may be improved by fentanyl, the ease of use of which may account for improved patient satisfaction and patient preference for fentanyl over oral morphine.

Keywords: Fentanyl, Chronic pain