Despite relative stable and adequately controlled background pain, Breakthrough Cancer Pain (BTcP) is a transient
exarcebation of pain that occurs either spontaneously or in relation to a specific predictable trigger. It is characterized
by a typical temporal pattern which includes a short onset (generally a few minutes) and a short duration (30-90 minutes).
It has a strong influence on quality of life (QoL), including detrimental effects on activities of daily living, sleep,
social relationships and enjoyment of life. Therefore, BTcP represents an important clinical challenge in the care of patients
with cancer. Transmucosal fentanyl, a rapid onset opioid (ROO), is indicated for the treatment of BTcP in patients
who are already receiving and are tolerant to opioid therapy for underlying, persistent pain. In order to identify published
studies on BTcP and ROOs a Medline search was carried out. The characteristics of the various formulations of transmucosal
fentanyl used for BTcP and clinical data published in literature will be described in this review.
Keywords: Breakthrough cancer pain, fentanyl, transmucosal delivery, rapid onset opioid, hydromorphon, subcutaneous route, transmucosal, bioavailability, morphine, nasal
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