Affordable Access

deepdyve-link
Publisher Website

Initial titration with 200 μg fentanyl buccal tablets: a retrospective safety analysis in Korean cancer patients.

Authors
  • Kwon, Mi-Young1
  • Cho, Ha-Na1
  • Koo, Dong-Hoe2
  • Lee, Yun-Gyoo2
  • Oh, Sukjoong2
  • Lee, Seung-Sei2
  • 1 Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, Korea. , (North Korea)
  • 2 Division of Hematology and Oncology, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. , (North Korea)
Type
Published Article
Journal
The Korean journal of internal medicine
Publication Date
May 01, 2018
Volume
33
Issue
3
Pages
577–584
Identifiers
DOI: 10.3904/kjim.2016.044
PMID: 28111431
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Managing breakthrough pain (BTP) is important for many cancer patients because of the rapid onset and unpredictable nature of the pain episodes. Fentanyl buccal tablets (FBTs) are a rapid-onset opioid indicated for BTP management. However, FBT titration is needed to optimize BTP management. In this study, we aimed to evaluate the safety and efficacy of initiating 200 μg FBTs in Korean cancer patients. A retrospective analysis of medical records was performed on all advanced cancer patients treated with FBTs for BTP between October 2014 and July 2015. Patients who received initial doses of 200 μg FBTs for at least 3 days and cases in which FBT was available at doses of 200, 400, and 800 μg were included. A total of 56 patients with a median age of 62 years (range, 32 to 80) were analyzed, 61% of whom were male. The median and mean values of morphine equivalent daily doses were 60 mg/day (range, 15 to 540) and 114.8 ± 124.8 mg/day, respectively. The most frequent effective doses of FBT were 200 μg (41 patients, 74%) and 400 μg (12 patients, 21%). Three patients (5%) could not tolerate 200 μg of FBT and discontinued treatment. Nausea, vomiting, somnolence, and dizziness were the most frequent treatment-related adverse events (AEs), and all AEs were grade 1 (mild) or 2 (moderate). FBT at the initial 200 μg dosage was well-tolerated and effective as a BTP management strategy in Korean cancer patients. Further prospective studies are needed to determine appropriate initiating doses of FBT in Korean patients with opioid tolerance.

Report this publication

Statistics

Seen <100 times