An Assessment of the Safety, Efficacy, and Acceptability of Intranasal Fentanyl Citrate in the Management of Cancer-Related Breakthrough Pain: A Pilot Study

J Pain Symptom Manage. 2000 Oct;20(4):253-8. doi: 10.1016/s0885-3924(00)00180-9.

Abstract

The effects of intranasal fentanyl citrate (INFC) were assessed in 12 hospice inpatients with cancer-related breakthrough pain. Patients received 20 microg of fentanyl citrate and were asked to rate their pain using a visual analogue scale (VAS) before INFC, then after 3, 5, 10, 15, 30, 45, and 60 minutes. Eight patients (66%) had reductions in pain scores, four within 5 minutes and seven within 10 minutes of taking INFC. Ratings for INFC were very good (5 = 42%), good (3 = 25%), moderate (1 = 8%), and bad (3 = 25%). In comparison to oral morphine, INFC was better (6 = 50%), the same (3 = 25%), or worse (3 = 25%). Nine patients (75%) said they would continue to use INFC. Of the three patients who did not experience a positive result, two were taking relatively higher baseline opioid doses and one was found to have a fracture. No systemic adverse events were noted; two patients reported nasal itching or discomfort on first use that disappeared with repeated use. Intranasal fentanyl citrate appears safe and well tolerated by these patients. Randomized placebo-controlled and dose-ranging studies are required to confirm these findings.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Intranasal*
  • Aged
  • Aged, 80 and over
  • Analgesia / statistics & numerical data
  • Dose-Response Relationship, Drug
  • Drug Interactions / physiology
  • Drug Therapy, Combination
  • Female
  • Fentanyl / administration & dosage*
  • Fentanyl / adverse effects*
  • Humans
  • Male
  • Middle Aged
  • Morphine / administration & dosage
  • Morphine / adverse effects
  • Neoplasms / complications
  • Neoplasms / drug therapy*
  • Neoplasms / physiopathology
  • Pain Measurement / drug effects*
  • Pain Measurement / psychology
  • Pain Measurement / statistics & numerical data
  • Pain, Intractable / drug therapy*
  • Pain, Intractable / etiology
  • Pain, Intractable / physiopathology
  • Pilot Projects
  • Terminally Ill / psychology
  • Treatment Outcome

Substances

  • Morphine
  • Fentanyl