VIENNA, AustriaManagement of breakthrough pain can sometimes be problematic in patients who are using transdermal fentanyl(Drug information on fentanyl) (Duragesic) as an alternative to morphine. Odette Spruyt, MD, reported at the 9th World Congress on Pain that sufentanil(Drug information on sufentanil) (Sufenta) used sublingually may help solve this problem. Dr. Spruyt is in the Palliative Care Service, Peter MacCallum Cancer Institute, East Melbourne, Victoria, Australia.
The researchers reviewed results in 16 patients with bone-related cancer pain taking sublingual doses of parenteral sufentanil at 250 µg/5 mL for breakthrough pain. Most patients were using the fentanyl patch. Two were receiving subcutaneous sufentanil infusions.
Doses of sublingual sufentanil ranged from 5 µg to 40 µg given up to every 2 hours. Dr. Spruyt said that the sublingual dose was generally effective and well tolerated. One patient discontinued it because sufentanil was not readily available in the community outpatient setting.
Sublingual parenteral sufentanil provides a simple and effective option, and may be especially useful for outpatient management, Dr. Spruyt said. Development of more suitable formulations of sufentanil for sublingual/transmucosal absorption would be useful.