• G Zeppetella.
• St Joseph's Hospice, London, UK. jzeppetella@stjosephshospice.org.uk
• Palliat Med. 2001 Jul 1; 15 (4): 323-8.

AbstractThe effects of sublingual fentanyl citrate (SLFC) were assessed in 11 hospice inpatients with cancer-related breakthrough pain. Patients were asked to rate their pain, using a visual analogue scale, before SLFC, then after 3, 5, 10, 15, 30, 45 and 60 min. Six patients (55%) had reductions in pain scores at 10 min and nine patients (82%) at 15 min. Ratings for SLFC were very good (18%), good (36%), moderate (28%), and bad (18%). Compared to the usual breakthrough medication, SLFC was better (46%), the same (36%), or worse (18%). Advantages of SLFC included ease of use, quick onset of action and no associated drowsiness. No systemic adverse events were noted, but two patients reported dry mouth and two a bitter taste. Two patients found it difficult to retain the medication under the tongue. Seven patients (64%) said they would continue to use SLFC. Sublingual fentanyl citrate appears safe and well tolerated by these patients. Randomized placebo-controlled and dose ranging studies are required to confirm these findings.

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