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  • Exposure to fentanyl after transdermal patch administration for cancer pain management

    Author(s)
    Bista, Sudeep R
    Haywood, Alison
    Hardy, Janet
    Norris, Ross
    Hennig, Stefanie
    Griffith University Author(s)
    Haywood, Alison
    Year published
    2016
    Metadata
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    Abstract
    This study aimed to describe exposure after fentanyl transdermal patch administration in patients with advanced cancer to quantify variability around the exposure. Patients (n = 56) with advanced cancer who received transdermal fentanyl (Durogesic®; median dose, 50 μg/h; range, 12–200 μg/h) provided venous blood samples (n = 163) at various times (0.5–72 hours) during several patch application intervals. Plasma fentanyl concentration was determined (median, 0.9 μg/L; range, 0.04–9.7 μg/L) by high‐performance liquid chromatography coupled to tandem mass spectrometry. Pharmacokinetic analysis was performed using nonlinear ...
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    This study aimed to describe exposure after fentanyl transdermal patch administration in patients with advanced cancer to quantify variability around the exposure. Patients (n = 56) with advanced cancer who received transdermal fentanyl (Durogesic®; median dose, 50 μg/h; range, 12–200 μg/h) provided venous blood samples (n = 163) at various times (0.5–72 hours) during several patch application intervals. Plasma fentanyl concentration was determined (median, 0.9 μg/L; range, 0.04–9.7 μg/L) by high‐performance liquid chromatography coupled to tandem mass spectrometry. Pharmacokinetic analysis was performed using nonlinear mixed‐effects modeling with NONMEM. A 1‐compartment distribution model with first‐order absorption and elimination described fentanyl exposure after transdermal patch administration. Fentanyl apparent clearance (between‐subject variability [BSV], %) was estimated at 122 L/h/70 kg and 38.5%, respectively. The absorption rate constant was 0.013 h−1. Between‐occasion variability on apparent clearance was 22.0%, which was lower than BSV, suggesting predictable exposure within the same patient and justifying therapeutic drug monitoring. Except for weight‐based dosing, no other patient characteristic could be identified to guide initial fentanyl dose selection in patients with advanced cancer.
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    Journal Title
    Journal of Clinical Pharmacology
    DOI
    https://doi.org/10.1002/jcph.641
    Note
    This publication has been entered into Griffith Research Online as an Advanced Online Version.
    Subject
    Pharmacology and pharmaceutical sciences
    Pharmaceutical sciences
    Publication URI
    http://hdl.handle.net/10072/99050
    Collection
    • Journal articles

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