Recommandations pour l'utilisation d'ACTIQ en pratique quotidienne

Oral transmucosal fentanyl citrate (ACTIQ) was specifically developed to provide rapid relief of paroxysmal pain in patients receiving morphine for chronic cancer pain. Mucosal absorption (25 % of oral dose) of fentanyl citrate enables immediate action. The remainder of the dose is swallowed and follows an enterohepatic cycle maintaining the analgesic effect through the acute episode. ACTIQ is supplied in tablet form with an oral applicator. ACTIQ requires individual titration to achieve optimal dose and minimal adverse effects. Two methods can be used: progressive dosing by small increments or dynamic dosing under careful surveillance by healthcare professionals. Once the effective dose has been determined, it should be used to treat each successive crisis. Disease progression or adverse effects may require a reevaluation of the optimal dose and a new adaptation of the effective dose. Withdrawal should be progressive, with morphine withdrawal, to avoid a weaning syndrome. ACTIQ is a safe easy-to-use method which has greatly improved treatment of acute episodes of cancer pain. Other indications may be developed in the future.