Transbuccal Fentanyl

Actiq® (fentanyl lollipop) 200 |g, 400 |g, 800 |g, 1,200 |g. Lozenge should be held against the inside of the cheek. Approximately 25% of the dose is absorbed directly through the buccal mucosa, the rest is swallowed and another 25% of the total dose is then slowly absorbed from the stomach. Tmax occurs in 20-40 min. Patient can remove the lozenge from the mouth if pain relief is obtained prior to full dissolution, discarding the rest of the lozenge. The lozenges contain sugar and can cause tooth decay if used frequently in the same area.

Fentora® (fentanyl buccal tablet) 100,200, 300,400, 600, 800 mcg dosing q4h. Dissolves rapidly. Following buccal administration of Fentora®®, fentanyl is readily absorbed with an absolute bioavailability of 65% (50% absorbed transmucosally, 15% absorbed through the gastrointestinal tract). Tmax occurs in approximately 45 min. Due to higher bioavailabil-ity, dosing is not equivalent from Actiq to Fentora®® - transition patients from Actiq per guidelines in Fentora package insert.

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