Anti-cancer drugs
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Multicenter Study Clinical Trial
Transdermal fentanyl: clinical development in the United States.
The first clinical experience in the United States of the transdermal therapeutic system (TTS) for delivery of fentanyl in cancer pain was a small study of five patients. Pain relief was established with intravenous (i.v.) fentanyl. A transdermal system was selected to deliver the same hourly dose while the i.v. infusion was tapered over 6 h. ⋯ The systems were used throughout a variety of concomitant complications of the cancer process. This experience demonstrated the safety and clinical effectiveness of TTS fentanyl in the treatment of chronic cancer pain. TTS fentanyl has been used widely in the USA since it was approved for marketing in 1990.
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Multicenter Study Clinical Trial
Transdermal fentanyl: a new step on the therapeutic ladder.
The high efficacy, low molecular weight and high lipid solubility of fentanyl make it a suitable agent for transdermal administration. Effective plasma concentrations are maintained for up to 48-72 hours after application of a transdermal therapeutic system (TTS) fentanyl patch. In a multicentre study, slow-release morphine was replaced by TTS fentanyl according to a special calculation table (10 mg oral morphine corresponding to approximately 0.1 mg TTS fentanyl). ⋯ Special indications for chronic pain therapy using transdermal opioids include head and neck and gastro-intestinal tract cancer. In these cases, TTS fentanyl may be the final non-invasive form of analgesic therapy which allows the patient to maintain a normal lifestyle. TTS fentanyl thus represents a new alternative for therapy with strong opioids on step III of the World Health Organization analgesic ladder.