Studies Confirm Effectiveness of Fentanyl Lozenges for Breakthrough Cancer Pain

Armen Hareyan's picture

Cancer Pain

The narcotic painkiller fentanyl relieves breakthrough pain quickly and more effectively than other narcotics and traditional drug therapy in patients with cancer, according to a systematic review of current evidence.

"When compared to placebo and morphine, participants gave lower pain intensity scores and higher pain relief scores for (the fentanyl lozenge) at all time points," concluded the review led by Giovambattista Zeppetella, M.D., of the St. Clare Hospice in England.

Breakthrough pain is moderate to severe sudden pain that interrupts otherwise controlled, persistent pain in people already taking pain medicine. The fentanyl lozenge, known as oral transmucosal fentanyl citrate, or OTFC, is also known by the brand name Actiq.


The review comprised four randomized controlled trials of a total 393 patients with cancer. Patients received OTFC for breakthrough pain and relief was compared with morphine or other opioid rescue medication, or placebo.

The review appears in the most recent issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

OTFC was specifically developed for breakthrough pain and approved by the FDA in 1998, and is used only by patients who are already taking other narcotic pain medications. It is exponentially more potent than morphine.

Current treatment for breakthrough pain typically involves so-called "rescue medication"