Transdermal fentanyl in children with cancer pain: feasibility, tolerability, and pharmacokinetic correlates. Academic Article uri icon

Overview

abstract

  • OBJECTIVES: (1) To assess the feasibility and tolerability of the therapeutic transdermal fentanyl system (TTS-fentanyl) by using a clinical protocol developed for children with cancer pain. (2) To estimate the pediatric pharmacokinetic parameters of TTS-fentanyl. METHODS: The drug was administered in open-label fashion; and measures of analgesia, side effects, and skin changes were obtained for a minimum of 2 doses (6 treatment days). Blood specimens were analyzed for plasma fentanyl concentrations. The pharmacokinetics of TTS-fentanyl were estimated by using a mixed effect modeling approach. RESULTS: Treatment was well tolerated. Ten of the 11 patients who completed the 2 doses continued treatment with TTS-fentanyl. The duration of treatment ranged from 6 to 275 days. The time to reach peak plasma concentration ranged from 18 hours to >66 hours in patients receiving the 25 microg/h patch. Compared with published pharmacokinetic data from adults, the mean clearance and volume of distribution of transdermal fentanyl were the same, but the variability was less. CONCLUSIONS: Treatment of children with TTS-fentanyl is feasible and well tolerated and yields fentanyl pharmacokinetic parameter estimates similar to those for adults. A larger study is required to confirm these findings and further test the clinical protocol.

publication date

  • March 1, 1999

Research

keywords

  • Analgesics, Opioid
  • Fentanyl
  • Neoplasms
  • Pain, Intractable

Identity

Scopus Document Identifier

  • 0033499792

Digital Object Identifier (DOI)

  • 10.1016/s0022-3476(99)70457-9

PubMed ID

  • 10064669

Additional Document Info

volume

  • 134

issue

  • 3