The role of oral transmucosal fetanyl citrate in the management of breakthrough cancer pain.

Breakthrough pain affects at least two-thirds of cancer patients at some point during their illness (Portenoy and Hagen, 1990; di Palma et al, 2000). The ideal preparation for managing breakthrough pain is one that is able to mirror its characteristics, i.e. rapid in onset and relatively short in duration. Oral transmucosal fentanyl citrate (OTFC, Actiq[R]) is an opioid formulation with a unique delivery system that fulfils these criteria. It has a role to play in the treatment of breakthrough pain for some patients who are receiving opioid treatment for cancer pain. OTFC was preferred over their routine medication by most patients who recently participated in a UK clinical trial (Hanks et al, 2002, unpublished data). This article aims to give an overview of this new and novel preparation developed for the control of breakthrough cancer pain.