Fentanyl iontophoretic transdermal system

Panchal and coworkers evaluated the incidence of analgesic gaps resulting from SREs for patients using the fentanyl iontophoretic transdermal system (ITS), a non-invasive PCA system, or morphine IV-PCA for post operative pain management [12]. For morphine IV-PCA, infiltration of the IV line was the most frequently reported SRE that resulted in an analgesic gap. Infiltration at the catheter site is a problem commonly encoimtered with IV-related procedures, and may result in IV line failure and/or a subcutaneous depot of opioid, leading to inadequate and ineffective delivery... 

Ranchal SJ, Damaraju CV, Nelson WW, Hewitt DJ, Schein JR. System-related events and analgesic gaps during postoperative pain management with the fentanyl iontophoretic transdermal system and morphine intravenous patient-controUed analgesia. Anesth Anal 2007 105(5) 1437-1441. 

Poon K-H, Tan K-H, Ho K-Y. Efficacy of fentanyl iontophoretic transdermal system in postoperative pain—a meta-analysis. Acute Pain 2009 11(2) 65-74. 

Parenteral (generic, Sublimaze) 50 mcg/mL for injection Fentanyl Transdermal System (Duragesic) 12.5, 25, 50, 75, 100 mcg/h delivery Fentanyl Buccal 100, 200, 400, 600, 800 meg oral lozenge Fentanyl Actiq 200, 400, 600, 800, 1200, 1600 meg lozenge on a stick Patient Controlled Transdermal Iontophoretic Fentanyl System 40 meg per dose for delivery Hydromorphone (generic, Dilaudid)... 

ChellyJE. An iontophoretic, fentanyl HC1 patient-controlled transdermal system for acute postoperative pain management. Expert Opin Pharmacother. 2005 6 1205-1214. 

Another product that uses iontophoresis has been recently approved by the FDA. This device is called Ionsys and is an iontophoretic system that delivers fentanyl hydrochloride transdermally [37, 38], This is a patient-controlled device that provides on-demand delivery of fentanyl for up to 24 h or 80 doses. This device contains 10.8 mg of fentanyl hydrochloride and is designed to deliver a 40-pg dose of fentanyl over a 10-min period upon activation of the dose button by the patient. 

Generic Name iontophoretic transdermal fentanyl delivery system Trade/Proprietary Name lONSYS ... 

Iontophoretic transdermal fentanyl (fentanyl ITS) was FDA-approved for short-term management of acute post-operative pain in hospitalized adults. The system is intended to be a patient-controlled method for maintenance of analgesia. Titration of a loading dose with opioids to an acceptable analgesic level prior to initiation of the system is recommended. Moreover, since the current (and hence the dose) are not adjustable, this system is most appropriate for opioid-naive patients and should not be preferred for opioid-tolerant subjects or those requiring a basal infusion. 

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