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Transdermal fentanyl: informed prescribing is essential.

Joy R Ross1, Columba Quigley

  • 1Department of Palliative Medicine, Royal Marsden Hospital, Fulham Road, London SW3 6JJ, UK.

European Journal of Pain (London, England)
|August 26, 2003
PubMed
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Transdermal fentanyl offers an alternative for cancer pain management when morphine is ineffective. However, improper prescribing, especially for unstable pain, can lead to dangerous opioid toxicity.

Area of Science:

  • Oncology
  • Pharmacology
  • Pain Management

Background:

  • Morphine is the standard for severe cancer pain but has limitations.
  • Some patients require alternative analgesics due to inadequate pain relief or side effects.
  • Transdermal fentanyl is a potent mu opioid agonist alternative.

Observation:

  • Transdermal fentanyl is effective for moderate to severe cancer pain.
  • Case reports highlight significant opioid toxicity risks.
  • Inappropriate prescribing, particularly in unstable pain, is a key concern.

Findings:

  • Transdermal fentanyl provides an alternative opioid for cancer pain.
  • Risks of opioid toxicity are associated with its use.
  • Careful patient selection and prescribing are crucial.

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Implications:

  • Highlights the need for cautious prescribing of transdermal fentanyl.
  • Emphasizes careful patient monitoring to prevent opioid toxicity.
  • Suggests alternative strategies for managing unstable cancer pain.