Oral transmucosal fentanyl citrate as breakthrough pain relieving medication: A pilot study

• Published in: Current medicine research and practice Vol. 14; no. 4; pp. 145 - 149
• Main Authors: Dua, Naresh, Annaram, Randheer Kumar, Jain, Pradeep, Yadav, Priya, Dua, Shubh, Sood, Jayashree
• Format: Journal Article
• Language: English
• Published: Medknow Publications and Media Pvt. Ltd 01.07.2024; Wolters Kluwer Medknow Publications
• Subjects: breakthrough pain; cancer pain; Care and treatment; Fentanyl; fentanyl citrate; Home care; Medical research; Medicine, Experimental; opioids; oral transmucosal fentanyl citrate; Pain; Patient compliance; rapid onset
• ISSN: 2352-0817
• DOI: 10.4103/cmrp.cmrp_72_24

ABSTRACT Background: Breakthrough pain in cancer patients is a common and distressing symptom that significantly impacts their quality of life. Traditional pain management strategies often fail to provide adequate relief. Oral transmucosal fentanyl citrate (OTFC) has emerged as a rapid-onset opioid analgesic, offering a potential solution for managing this challenging condition in home care settings. Aims: This study aims to evaluate the efficacy of OTFC in managing breakthrough pain and its effects on the quality of life in cancer patients treated at home. Materials and Methods: A pilot study was conducted with 40 cancer patients experiencing more than one episode of breakthrough pain daily. These patients were administered OTFC 400 μg for pain management. Degree of pain (NRS) and modified ‘Quality of Well-being' (QWB) scores were analysed using data filled in by patients. Data were collected and analysed using paired t-tests to compare pre- and post-treatment scores. Results: The administration of OTFC resulted in a significant reduction in pain, as indicated by the decrease in NRS scores from 9.9 ± 0.304 to 0.5 ± 0.906 within 30 minutes (P < 0.0001). Additionally, there was a marked improvement in QWB scores, which increased from 26.18 ± 2.8 to 36.3 ± 3.16 over the same period (P < 0.001). Mild side effects, such as nausea, headache, and somnolence, were reported, but no serious adverse events were observed. Conclusions: We conclude that OTFC 400 μg is an effective and well-tolerated option for managing breakthrough pain in cancer patients and in improving the quality of life in home care settings. Keywords: Breakthrough pain, cancer pain, fentanyl citrate, opioids, oral transmucosal fentanyl citrate, rapid onset