PMID- 28111431
OWN - NLM
STAT- MEDLINE
DCOM- 20190308
LR  - 20190308
IS  - 2005-6648 (Electronic)
IS  - 1226-3303 (Print)
IS  - 1226-3303 (Linking)
VI  - 33
IP  - 3
DP  - 2018 May
TI  - Initial titration with 200 mug fentanyl buccal tablets: a retrospective safety 
      analysis in Korean cancer patients.
PG  - 577-584
LID - 10.3904/kjim.2016.044 [doi]
AB  - BACKGROUND/AIMS: Managing breakthrough pain (BTP) is important for many cancer 
      patients because of the rapid onset and unpredictable nature of the pain 
      episodes. Fentanyl buccal tablets (FBTs) are a rapid-onset opioid indicated for 
      BTP management. However, FBT titration is needed to optimize BTP management. In 
      this study, we aimed to evaluate the safety and efficacy of initiating 200 mug 
      FBTs in Korean cancer patients. METHODS: A retrospective analysis of medical 
      records was performed on all advanced cancer patients treated with FBTs for BTP 
      between October 2014 and July 2015. Patients who received initial doses of 200 mug 
      FBTs for at least 3 days and cases in which FBT was available at doses of 200, 
      400, and 800 mug were included. RESULTS: A total of 56 patients with a median age 
      of 62 years (range, 32 to 80) were analyzed, 61% of whom were male. The median 
      and mean values of morphine equivalent daily doses were 60 mg/day (range, 15 to 
      540) and 114.8 +/- 124.8 mg/day, respectively. The most frequent effective doses of 
      FBT were 200 mug (41 patients, 74%) and 400 mug (12 patients, 21%). Three patients 
      (5%) could not tolerate 200 mug of FBT and discontinued treatment. Nausea, 
      vomiting, somnolence, and dizziness were the most frequent treatment-related 
      adverse events (AEs), and all AEs were grade 1 (mild) or 2 (moderate). 
      CONCLUSIONS: FBT at the initial 200 mug dosage was well-tolerated and effective as 
      a BTP management strategy in Korean cancer patients. Further prospective studies 
      are needed to determine appropriate initiating doses of FBT in Korean patients 
      with opioid tolerance.
FAU - Kwon, Mi-Young
AU  - Kwon MY
AD  - Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, 
      Korea.
FAU - Cho, Ha-Na
AU  - Cho HN
AD  - Department of Anesthesiology and Pain Medicine, National Medical Center, Seoul, 
      Korea.
FAU - Koo, Dong-Hoe
AU  - Koo DH
AD  - Division of Hematology and Oncology, Department of Internal Medicine, Kangbuk 
      Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Lee, Yun-Gyoo
AU  - Lee YG
AD  - Division of Hematology and Oncology, Department of Internal Medicine, Kangbuk 
      Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Oh, Sukjoong
AU  - Oh S
AD  - Division of Hematology and Oncology, Department of Internal Medicine, Kangbuk 
      Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
FAU - Lee, Seung-Sei
AU  - Lee SS
AD  - Division of Hematology and Oncology, Department of Internal Medicine, Kangbuk 
      Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
LA  - eng
PT  - Journal Article
DEP - 20170124
PL  - Korea (South)
TA  - Korean J Intern Med
JT  - The Korean journal of internal medicine
JID - 8712418
RN  - 0 (Analgesics, Opioid)
RN  - 0 (Tablets)
RN  - UF599785JZ (Fentanyl)
SB  - IM
MH  - Administration, Buccal
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - *Analgesics, Opioid/administration & dosage
MH  - *Breakthrough Pain/drug therapy/etiology
MH  - Female
MH  - *Fentanyl/administration & dosage
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Neoplasms/complications
MH  - *Pain Management
MH  - Pain Measurement
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - Tablets
MH  - Treatment Outcome
MH  - Young Adult
PMC - PMC5943645
OTO - NOTNLM
OT  - Analgesics, opioid
OT  - Breakthrough pain
OT  - Fentanyl
OT  - Neoplasms
COIS- No potential conflict of interest relevant to this article was reported.
EDAT- 2017/01/24 06:00
MHDA- 2019/03/09 06:00
PMCR- 2018/05/01
CRDT- 2017/01/24 06:00
PHST- 2016/02/15 00:00 [received]
PHST- 2016/08/26 00:00 [revised]
PHST- 2016/09/28 00:00 [accepted]
PHST- 2017/01/24 06:00 [pubmed]
PHST- 2019/03/09 06:00 [medline]
PHST- 2017/01/24 06:00 [entrez]
PHST- 2018/05/01 00:00 [pmc-release]
AID - kjim.2016.044 [pii]
AID - kjim-2016-044 [pii]
AID - 10.3904/kjim.2016.044 [doi]
PST - ppublish
SO  - Korean J Intern Med. 2018 May;33(3):577-584. doi: 10.3904/kjim.2016.044. Epub 
      2017 Jan 24.