Vías de administración de fentanilo para el tratamiento del dolor irruptivo oncológico

Breakthrough pain is defined as a transitory exacerbation of pain occurring in a patient with well-controlled background pain. This type of pain is highly common in cancer patients. Due to the characteristics of breakthrough pain, the opioid used in its treatment must be potent, fast-acting, with a short effect, and easy to administer. Consequently, the ideal drug for the treatment of breakthrough pain is fentanyl. The present review analyzes 5 routes of fentanyl administration, its mechanisms of action, its pharmacokinetic profiles and its efficacy. A search was made using the words «breakthrough pain», «cancer» and «fentanyl» and/or «routes of administration». The pharmacokinetic profile of fentanyl pectin nasal spray (PecFent®) is perfectly tailored to the characteristics of breakthrough cancer pain. Intranasal administration is convenient and easy for the patient. This drug can be used in patients with intolerance to the oral route. It is able to provide a rapid and uniform analgesic response during repeat administrations. For these reasons, it can be considered the drug of choice in cancer patients with poorly-controlled breakthrough pain.