FENTANYL TRANSDERMAL SYSTEM - PAIN MANAGEMENT AT HOME

PROBLEM BEING ADDRESSED About 65% of patients with advanced malignanci es experience cancer pain. Although oral opioids provide effective ana lgesia for most of these patients, alternate routes of drug delivery a re often necessary as the disease progresses. PURPOSE OF PROGRAM To st udy use of Duragesic (fentanyl transdermal system), the only transderm al opioid approved in Canada for treating chronic cancer pain in adult s. MAIN COMPONENTS Transdermal fentanyl was prescribed for a heterogen eous group of 44 patients (aged 29 to 82 years) to treat cancer pain ( 37 patients), chronic non-malignant pain (six patients), and pain asso ciated with terminal AIDS (one patient) for periods of 2 to 384 days. Patients were treated individually and switched to transdermal fentany l from other opioids when oral delivery was no longer possible. Doses were titrated as necessary and ranged from 25 mu g/h to 300 mu g/h. In cidental pain was treated effectively with short-acting opioids. CONCL USIONS Eighty percent of patients experienced good analgesia, which le d to an overall improvement in their quality of life. Transdermal fent anyl was discontinued for 17% of patients due to intractable nausea, d iarrhea, adherence problems, or poor analgesia. Many patients wore the system until they died or until a few days before death when severe i ncreasing pain necessitated parenteral opioids. The side effects of tr ansdermal fentanyl were similar to those of conventional opioids. Pati ent compliance and acceptance of this noninvasive, continuous system o f drug delivery has been excellent; its simplicity of administration a llows patients to be cared for at home.