Treatment with subcutaneous and transdermal fentanyl: results from a population pharmacokinetic study in cancer patients

European Journal of Clinical Pharmacology
Astrid W OostenRon H J Mathijssen

Abstract

Transdermal fentanyl is effective for the treatment of moderate to severe cancer-related pain but is unsuitable for fast titration. In this setting, continuous subcutaneous fentanyl may be used. As data on the pharmacokinetics of continuous subcutaneous fentanyl are lacking, we studied the pharmacokinetics of subcutaneous and transdermal fentanyl. Furthermore, we evaluated rotations from the subcutaneous to the transdermal route. Fifty-two patients treated with subcutaneous and/or transdermal fentanyl for moderate to severe cancer-related pain participated. A population pharmacokinetic model was developed and evaluated using non-linear mixed-effects modelling. For rotations from subcutaneous to transdermal fentanyl, a 1:1 dose conversion ratio was used while the subcutaneous infusion was continued for 12 h (with a 50 % tapering after 6 h). A 6-h scheme with 50 % tapering after 3 h was simulated using the final model. A one-compartment model with first-order elimination and separate first-order absorption processes for each route adequately described the data. The estimated apparent clearance of fentanyl was 49.6 L/h; the absorption rate constant for subcutaneous and transdermal fentanyl was 0.0358 and 0.0135 h(-1), respectively...Continue Reading

References

Jun 1, 1989·Anesthesiology·J R VarvelD R Stanski
Jul 1, 1980·Clinical Pharmacology and Therapeutics·D A McClain, C C Hug
Dec 1, 1993·Journal of Pharmacokinetics and Biopharmaceutics·M O Karlsson, L B Sheiner
Jan 1, 1993·Anesthesiology·R K PortenoyK M Foley
Dec 10, 1998·Journal of Pain and Symptom Management·S WatanabeE Bruera
Apr 9, 1999·Computer Methods and Programs in Biomedicine·E N Jonsson, M O Karlsson
Sep 15, 1999·Journal of Pain and Symptom Management·R HuntM Brooksbank
Feb 11, 2000·Clinical Pharmacokinetics·S GrondK A Lehmann
Jun 24, 2004·Computer Methods and Programs in Biomedicine·Lars LindbomE Niclas Jonsson
Jul 19, 2005·Computer Methods and Programs in Biomedicine·Lars LindbomNiclas Jonsson
Jun 16, 2007·Clinical Pharmacology and Therapeutics·M O Karlsson, R M Savic
Nov 18, 2009·European Journal of Anaesthesiology·Sarah J CapperGuy L Ludbrook
Feb 16, 2010·European Journal of Pharmaceutics and Biopharmaceutics : Official Journal of Arbeitsgemeinschaft Für Pharmazeutische Verfahrenstechnik E.V·Hans G KressThomas Wagner
Mar 10, 2010·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Do-Yeun KimSi-Young Kim
Jun 16, 2010·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Motoo NomuraSatoshi Sawada
Feb 9, 2011·The AAPS Journal·Martin BergstrandMats O Karlsson
Feb 4, 2012·The Lancet Oncology·Augusto CaraceniUNKNOWN European Association for Palliative Care (EAPC)
Jul 7, 2012·Journal of Pain & Palliative Care Pharmacotherapy·Hideya KokubunKazuo Yago
Jan 16, 2014·International Journal of Clinical Pharmacology and Therapeutics·Ji Liu, Xiao Zhou
Sep 19, 2015·Journal of Clinical Pharmacology·Sudeep R BistaStefanie Hennig

❮ Previous
Next ❯

Citations

Oct 30, 2016·British Journal of Clinical Pharmacology·Evelien J M KuipCarin C D van der Rijt
Mar 28, 2017·Pharmacogenomics·Stijn Lw Koolen, Carin Cd Van der Rijt
Oct 28, 2019·Clinical Pharmacokinetics·Belén P SolansIñaki F Trocóniz
Sep 3, 2020·Indian Journal of Palliative Care·Raghavendra RamanjuluDipasri Bhattacharya
Oct 17, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Tony PriestleyStephen Camper
Aug 11, 2020·Anesthesia and Analgesia·Kyle T HerndonJason J Braithwaite
Feb 7, 2021·International Journal of Biological Macromolecules·Han-Seong KimSoon-Do Yoon
Nov 18, 2020·International Journal of Obstetric Anesthesia·J FleetA M Cyna
Oct 21, 2020·Anesthesia and Analgesia·Kyle T HerndonJason J Braithwaite
Apr 4, 2021·European Journal of Clinical Pharmacology·Aymen A Al-QurainMichael D Wiese
Dec 31, 2020·Thérapie·Lucie-Marie ScailteuxUNKNOWN et le réseau français des Centres régionaux de pharmacovigilance

❮ Previous
Next ❯

Software Mentioned

Xpose
NONMEM

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.