The use of transdermal fentanyl in the treatment of cancer pain

The management of pain is complex having to take into consideration patient specific characteristics. Drug therapy should be individualized and managed based on numerous factors. The opioid of first choice for the treatment of cancer pain is morphine, according to the European Association for Palliative Care (2000). Transdermally administered fentanyl is one alternative to oral morphine in the treatment of cancer pain. The transdermal systems are designed to deliver fentanyl at a constant rate for periods of 72 hours. Patches with a delivery rate of 25, 50, 75 and 100 µg/h are available. Treatment with transdermal fentanyl is safe and acceptable to many cancer patients. Significantly more patients expressed a preference for transdermal fentanyl than for sustained release oral morphine. The global score of adverse effects was significantly lower in patients receiving transdermal fentanyl than in those receiving sustained release oral morphine. The transdermal fentanyl patch is as effective as oral opioids in relieving cancer related pain, with a safety and side effect profile equal to or better than that of oral opioids