Treatment strategies to overcome end-of-dose failure with oral and transdermal opioids.

Extended-release oral and transdermal opioids are increasingly being used for the management of chronic pain. Although the dosing intervals for these products were established through controlled clinical trials, expanded use of extended-release and transdermal dosage forms has resulted in awareness that a significant number of patients with chronic pain experience loss of baseline pain control prior to the next scheduled dose. End-of-dose failure (EDF) is the term used to describe this type of pain manifestation. By recognizing potential causes of EDF, strategies may be developed to overcome its occurrence to improve patients' pain control.