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Updated: Aug 16, 2026

Trans-Tympanic Drug Delivery for the Treatment of Ototoxicity
Published on: March 16, 2018
Evidence-based oral transmucosal fentanyl citrate (OTFC) dosing guidelines
Gerald M Aronoff1, Michael J Brennan, Douglas D Pritchard
1Carolina Pain Associates, Presbyterian Orthopedic Hospital, Charlotte, NC 28207, USA. geraldaronoffmd@msn.com
Objective:
To review the evidence for dosing and efficacy of oral transmucosal fentanyl citrate in the management of pain and produce dosing guidelines.
Design:
The scientific literature pertaining to oral transmucosal fentanyl citrate was reviewed, focusing upon its pharmacology and clinical experience with use in cancer and noncancer pain. Emphasis was upon published, peer-reviewed English language articles.
Results:
Information was crucially examined and synthesized into guidelines for use and dosing of oral transmucosal fentanyl citrate in cancer and noncancer pain.
Conclusions:
Oral transmucosal fentanyl citrate is a potent opioid delivery system, which, when used appropriately, is an effective treatment option for pain. Adherence to guidelines should promote its safe and efficacious use in a variety of clinical pain management settings.
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