Exposure to fentanyl after transdermal patch administration for cancer pain management

Bista, Sudeep R., Haywood, Alison, Hardy, Janet, Norris, Ross and Hennig, Stefanie (2015) Exposure to fentanyl after transdermal patch administration for cancer pain management. Journal of Clinical Pharmacology, 56 6: 705-713. doi:10.1002/jcph.641

Author Bista, Sudeep R.
Haywood, Alison
Hardy, Janet
Norris, Ross
Hennig, Stefanie
Title Exposure to fentanyl after transdermal patch administration for cancer pain management
Journal name Journal of Clinical Pharmacology   Check publisher's open access policy
ISSN 0091-2700
Publication date 2015
Sub-type Article (original research)
DOI 10.1002/jcph.641
Volume 56
Issue 6
Start page 705
End page 713
Total pages 9
Place of publication Hoboken, NJ, United States
Publisher Wiley-Blackwell
Collection year 2016
Language eng
Formatted 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 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.
Keyword Population pharmacokinetics
Transdermal patch
Cancer pain
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Mater Research Institute-UQ (MRI-UQ)
Official 2016 Collection
School of Medicine Publications
School of Pharmacy Publications
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Created: Mon, 19 Oct 2015, 15:29:32 EST by Dr Stefanie Hennig on behalf of School of Pharmacy