The use of rotation to fentanyl in cancer-related pain

Abstract

Pain is commonly diagnosed with respect to cancer and heart diseases, being a major symptom in most neoplastic diseases. Uncontrolled pain leads to a decrease in the quality of life and an increase in the morbidity of the patient. Opioids represent the best analgetic supportive therapy and are frequently used in patients suffering from cancer and experiencing a high level of pain. Opioid treatment starts with a gradual titration of the dose until the minimum effective dose and the maximum tolerated dose are determined. Opioid rotation refers to the switch from one opioid to another in order to get a better response to analgetic therapy and reduce side effects. Fentanyl therapy is recommended to be continued during chemotherapy, radiotherapy, or in the case of surgical intervention. Rotation to fentanyl patches is an efficient and elegant solution for cancer patients, with reduced side effects. Opioid rotation, especially to fentanyl, was shown to increase the quality of life in patients with malignant disease. Finally, rotation to fentanyl is also advantageous from an economic point of view.

Keywords:

• opioid rotation
• cancer-related pain
• fentanyl

Acknowledgments

This work was supported by grants from the Romanian National Authority for Scientific Research and Innovation, CNCS – UEFISCDI, project number PN-II-RU-TE-2014-4-2074 (to M Zdrenghea) and PN-II-RU-TE-2014-4-1783 (to C Tomuleasa), a Romania–Norway grant awarded to C Tomuleasa and I Berindan-Neagoe (F-SEE-027, 1/25.06.2015), and a doctoral grant awarded to I Frinc by the Iuliu Hatieganu University of Medicine and Pharmacy

Disclosure

The authors report no conflicts of interest in this work.