Oral transmucosal fentanyl citrates

Zhang J, Niu S, Maland LJ, Barrus BK, Freimann VR, Hague BI (1991b) Buccal permeability of oral transmucosal fentanyl citrate (OTFCTM) in a dog model. Pharm Res 8 S-155... 

Streisand, J.B., et al. 1991. Absorption and bioavailability of oral transmucosal fentanyl citrate. 

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). 

Sharar SR, Carrougher GJ, Selzer K, O Donnell F, Vavilala MS, Lee LA. A comparison of oral transmucosal fentanyl citrate and oral oxycodone for pediatric outpatient wound care. J Burn Care Rehabil 2002 23(1) 27-31. 

Gordon, D.B. (2006) Oral transmucosal fentanyl citrate for cancer breakthrough pain a review. Oncology Nursing Forum, 33, 257-264. 

Kharasch ED, Whittington D, Hoffer C. Influence of hepatic and intestinal cytochrome P4503A activity on the acute disposition and effects of oral transmucosal fentanyl citrate. Anesthesiology (2004) 101, 729-37. 

Farrar JT, Cleary J, Rauck R, Busch M, Nordbrock E. Oral transmucosal fentanyl citrate randomized, double-blinded, placebo-controlled trial for treatment of breakthrough pain in cancer patients. / Nat/ Cancer Inst 1998 90 611-616. 

R. Nave, H. Schmitt, L. Popper, Faster absorption and higher systemic bioavailability of intranasal fentanyl spray compared to oral transmucosal fentanyl citrate in healthy subjects. Drug Delivery 20 (2013), p. 216-223. 

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