Oral transmucosal fentanyl citrate for cancer breakthrough pain: a review.

PURPOSE/OBJECTIVES To review the dose titration, efficacy, and safety of oral transmucosal fentanyl citrate (OTFC). DATA SOURCES Phase I and II clinical trial abstracts and evidence-based review articles. DATA SYNTHESIS OTFC has an onset, peak, and duration of action similar to that of an IV dose of an opioid and has been demonstrated to be effective and well tolerated for the management of breakthrough pain in patients with cancer. CONCLUSIONS Studies of OTFC demonstrate that it is easy to use,noninvasive, effective, safe, and acceptable to patients, caregivers, and healthcare providers. However, OTFC is expensive and approved for use only in opioid-tolerant patients with cancer. IMPLICATIONS FOR NURSING Breakthrough pain in patients with cancer is a common problem with characteristics that make it difficult to treat. Oncology nurses should familiarize themselves with OTFC's unique characteristics to be able to best help patients manage their therapy.