Long-term observations of patients receiving transdermal fentanyl after a randomized trial

We observed 73 cancer patients receiving transdermal fentanyl fro 1-29 (mea n 5.5) months immediately after participation in a randomised clinical tria l. Of these, 32 received fentanyl until death, 18 were lost to follow-up, 1 1 required alternative analgesia, and 12 withdrew for other reasons. The me dian first recorded dose (not necessarily the patient's first fentanyl dose ) was 75 mug/h. The median dose was 100 mug/h. All but 3 patients required < 300 mug fentanyl/h. In the 16 who received fentanyl for greater than or e qual to3 months until death, the median dose was unchanged (100 mug/h) 3 mo nths before death and at death; 8/16 required no dosage change. The inciden ce of constipation, skin reactions, nausea, and vomiting was low. No signif icant respiratory depression was associated with fentanyl. Most patients (8 5%) and investigators (86%) rated the treatment as good or excellent. We co nclude that long-term treatment with transdermal fentanyl is safe and accep table to many cancer patients. (C) U.S. Cancer Pain Relief Committee, 2001.