Super Quick Answer Needed! on FENTANYL FORMULATIONS/PREPARATIONS!

[Rybee]

Hey All,

Sorry for the need to know ASAP but I'm off to my doctor's in ~4 hours and I'd like to do a bit of homework on this before I see him.

Basically I'm on 25mcg p/h Fentanyl patches but I'm allergic to the zinc in the adhesive so I need to come off of the patches and either take a different formulation, or rotate to Morphine or Oxycontin or Tapentadol or something.

I do like Fentanyl so would like to keep on it, but what other preparations/formulations does it come in?

Ideally I'd be after an ER/SR/XR version of Fentanyl, so a slow release tablet tablet would be ideal - but I have never seen them? Do they even exist? And if so, why are transdermal patches always px'd in preference of them?

Ry x

 

[T. Calderone]

I'm in the U.S. so I'm not sure if fentanyl lollipops are available where you live. I knew a cancer patient who was prescribed them.

 

[thebesttussin]

Ask your doctor about the Actiq lollipop. It's the closest thing to what you're describing. Also, you have the option of the instant release nasal spray.

 

[Rybee]

Is there any reason that Fentanyl doesn't seem to come in an extended release formula?

 

[Deleted member 80237]

The patches are extended release. I think Actiq is too, at least if used as directed. It isn't made in pill form, ER or otherwise, because a) such small doses are used that it would be a ridiculous amount of filler even to reach small tablet size and b) oral bio-availability isn't great.

Edit: Wiki has oral BA at 33%, even lower than I thought, versus 92 for the patch, 50 for the lollipop. (89 for the nasal spray)
So with such a low BA, an oral pill would have to contain a larger dose to be therapeutically active. And that's a pretty big safety concern, since easily-snortable fent is not something most people need access too, especially in large doses. So safety is probably the biggest reason.

 

[Runtoparadise]

Fent doesn't come in tablet form, as posted above. That's where it fills it's niche, the strongest opiate available, with a unique delivery system.

Actiq, to my knowledge, is a BT med. Avail here,(oz), under the indication of malignancy only.

@Rybee, this is too late for your question, but how serious is your Zinc allergy?

IME I have always had a itch & red rash from the patches..but also IME, if you find good pain relief it's usually worth sticking with despite the side effects.

Anyway, from the opiates you've listed it sounds as though you have a sound knowledge of pain management, so let us know how you've gotten on at the doctor.

If you could post it over on the chronic pain megathread too, it may help another CPP.

Cheers,

Rtp