Fentanyl lozenge

Over the years it has been interesting to note that many compounded products eventually become commercially available products. Recent examples might include fentanyl lozenges, minoxidil topical solution, nystatin lozenges, clindamycin topical solution, tetracaine-adrenalin-cocaine (TAG) solution, dihydroergotamine mesylate nasal spray, buprenorphine nasal spray, buffered hypertonic saline solution, and erythromycin topical solution as well as numerous other dermatological and pediatric oral liquids and some... 

Fentanyl lozenge is absorbed transmucosally. It is useful for providing analgesia during painful procedures. Advantages of this product include rapid onset of action (within 15 min), short duration of action (60-90 min), and painless administration because no injection is needed. A common side effect is vomiting and mild to moderate oxygen desaturation. Doses of 10-15 mcg/kg provide blood levels equivalent to 3-5 mcg/kg IV. 

Fentanyl buccal tablet (Fentora) and fentanyl lozenge (Actiq) both contain fentanyl, an opioid agonist and a Schedule II controlled substance, with a potential abuse similar to other opioid analgesics. Fentora is... 

Adverse events there is a greater risk of abuse of both fentanyl buccal tablets and fentanyl lozenges since they are both taken orally. Fentanyl oralet has been shown to have variabihty in fentanyl availability because of variation in patient mouth surface area, and the percentage of medication that is absorbed through oral mucosa versus the percentage swallowed. 

The most common adverse events seen with fentanyl buccal tablets and fentanyl lozenges are typical of opioid side effects. The most serious adverse reactions with all opiods include respiratory depression, circulatory depression, hypotension, and shock. Other common opioid side effects include nausea, vomiting, fatigue, dizziness, drowsiness, constipation, and headache. Dental caries has been reported with the use of fentanyl oralet. A minor adverse event with fentanyl buccal tablets is mouth ulcer. 

Fentanyl (Sublimaze) and its related phenylpiperidine derivatives are extremely potent drugs. They are used as adjuncts to anesthesia, and fentanyl may be given trans-dermally as an analgesic and as an oral lozenge for the induction of anesthesia, especially in children who may become anxious if given IV anesthesia. 

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)... 

Iontophoresis techniques (i.e., the use of electric current to facilitate transdermal delivery) have also been advocated as a way to enhance transdermal opioid delivery to the systemic circulation.11 By varying the amount of electric current, iontophoresis may ultimately allow the patient to control the rate of transdermal administration of the opioid.10,76,78 Finally, certain opioids such as fentanyl can be administered systemically via lozenges or a lollipop that dissolves in the mouth (transmucosal delivery), or via nasal spray (intranasal administration).21,54 It will be interesting to see if these newer methods of administration will gain widespread acceptance in the future. 

Oral ingestion of fentanyl is the most common way it is used to relieve chronic pain today. This is achieved primarily in a lollipop or lozenge that allows for a slow ingestion into the body. Most of the lollipops and lozenges are cherry flavored for children in cancer wards, this is the preferred method of administration because they seldom view the treats as medication. Rectal administration is sometimes used as well if the patient cannot receive oral medication or if they have a strong nausea reaction to the fentanyl. This method is used only as a last resort, and few patients opt for it. 

Oral transmucosal fentanyl citrate has two advantages it is more acceptable as a flavored lozenge than an oral elixir or tablet would be, especially in children, and 25% goes directly into the systemic circulation without first-pass metabolism (SEDA-20, 77). Its main adverse effect is dose-dependent nausea and/or vomiting, which occurs in 25-50% of patients. In a double-blind, placebo-controlled comparison of oral transmucosal fentanyl citrate (10 pg/kg) and oral oxycodone (0.2 mg/kg) in outpatient wound care procedures in 22 children, there were similar outcomes and no adverse effects in either group (40). 

Actiq (Fentanyl citrate lozenge). Cephalon Ltd. UK Summary of product characteristics, October 2005. 

Fentanyl citrate Buccal Lozenge Actiq Teva Pharmaceuticals... 

Lozenges Use Palliative for sore throats, dmg delivery, e.g. fentanyl. Advantage Nice taste. Issues Tooth decay, effectiveness, coverage. 

---