All the Therapeutic System Drugs
Opioid. Fentanyl (as Citrate) 100, 200, 300, 400, 600, 800 mcg. SUBLING. TABS: 10, 30 x 100 μg, 200 μg,
300 μg , 400 μg, 600 μg, 800 μg.
Initial: 100 μg. subling., not be
swallowed, chewed oe sucked. Titr.
upwards as necess. See lit.
Manag. of breakthr. pain in adult pts using
opioid ther. for chronic cancer pain.
Breakthr. pain is a transient exacerb. of
otherwise control. chronic background
C/I: Hypersens.; Opioid-naïve pts due to
the risk of life-threat. resp. depress.;
Sev. resp. depress. or sev. obstr. lung
cond.; acute or post-oper. pain, incl.
headache/migraine, dental pain, or use in
Opioid. Fentanyl (as citrate) 200, 400, 600, 800, 1200, 1600 mcg/dose. COMPRESSED TAB. ON HANDLE
(lozenge): 30. Initial: 200 μg. To supply
only 6 x 200 μg and to use all units bef. incr. to higher dose. See lit. Unit to be
sucked, not chewed over 15 mins.
Discont: Grad. downward titrat.
Manage. breakthrough cancer pain in pts
16 and older with maligns. who are
already receiv. and tolerant to opioid ther.
for persist. cancer pain.
C/I: Post-op. pain, opioid non-tol.,
hypersens./intol. to fentanyl, anaphylax.
Opioid. Buprenorphine 5, 10, 15, 20 mg. TRANSDERMAL 7-DAY MATRIX PATCHES:
Butrans 5: 2 x 5 mg/patch (5 μg/hr);
Butrans 10: 2 x 10 mg (10 μg/hr);
Bytrans 15: 15 mg (15μg/hr);
Butrans 20: 2 x 20 mg (20 μg/hr).
Should be applied every 7 days.
Not for acute pain. Patients aged 18 years and over: Initial: BuTrans 5,
depend. opioid history, current gen.
cond., medical status. Pts. should use
usual recommend. doses of short-act.
supplement. analgesics as needed
until analgesic effecacy is attained.
Titrat.: The dose may be titr. upwards as indic. after 3 d., when the max. effect of a
given dose is establish. Subsequent dosage increases may then be titrated based on the need for supplem. pain relief and the pt’s. analges. response to the patch.
To incr. the dose, a larger patch should replace the patch that is current. being
worn, or a comb. of patches should be appl. in differ. places to achieve the
desired dose. It is recom. that no more than two patches are appl. at the same
time, up to (and includ.) a max. total dose of 40mcg/h. A new patch should not
be appl. to the same skin site for the subseq.3-4 wks. See lit.
Tmt. mod.-severe opioid respons. chron.
pain conds. not adequat. respond. to
Hypersens. Opioid depend. pts. and for narcotic withdrawal tmt. Condit. in which the respirat. centre and funct. are sever. impaired or may become so. Pts. who are receiving MAO inhib. or have taken them within the last 2 wks. Pts.suffer. from myasthenia g. Pts.suffer. from delirium tremens.
Opioid. Fentanyl 12.5, 25, 50, 75, 100 mcg/hour. TRANSDERMAL 3-DAY MATRIX PATCHES:
5 x 12.5 μg/hr (2.063 mg/patch); 5 x 25 μg/hr (4.125 mg/patch); 5 x 50 μg/hr
(8.25 mg/patch); 5 x 75 μg/hr (12.375
mg/patch); 5 x 100 μg/hr (16.5 mg/
patch). Initial: Depend. on pts. current
cond., intensity of pain, opioid history.
Dose titrat: Initial dose may be incr.
aft. 3 days with patch replacement;
then titrate every 6 days. See lit.
Breakthrough pain may be treated
with supplement. short-act. analges.
Discont. when necess., gradually.
Manage. chron./intract. pain req. opioid
analges. See lit.
C/I: Opioid intoler., post-op. pain, acute
pain, mild-mod. pain. Concurrent with