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NOTICE: Kyowa Kirin International has agreed a joint venture with Grünenthal GmbH for the Established Medicines portfolio. The new company, KKI NewCo (known as Grünenthal Meds), is responsible for the content on this page. For more information please click here.
Abstral® is indicated for the management of breakthrough pain in adult patients using opioid therapy for chronic cancer pain. Breakthrough pain is a transient exacerbation of otherwise controlled chronic background pain.*1
Adverse Events should be reported. Reporting forms and information can be found at www.mhra.gov.uk/yellowcard. Adverse Events should also be reported to Kyowa Kirin International UK NewCo Ltd, known as Grünenthal Meds on +44 (0)1896 664000, email PVUK@grunenthalmeds.com
Click here for Prescribing Information.
The dose of Abstral® must be individually titrated, under supervision, until the optimal maintenance dose is reached. The optimal dose is defined as that which provides adequate analgesia to manage BTcP episodes with an acceptable level of adverse effects.
Particular caution should be exercised during dose titration in patients with chronic obstructive pulmonary disease or other medical conditions predisposing them to respiratory depression (e.g. myasthenia gravis), because of the risk of further respiratory depression which could lead to respiratory failure.1
The starting dose of Abstral® is 100 micrograms in all cases, titrating upwards as shown in the algorithm above. This includes patients switching to Abstral® from other opioids (including other transmucosal fentanyls) for the treatment of BTcP.
It is important to be aware that the pharmacokinetics of these products vary and so they are not interchangeable. This applies to different formulations of fentanyl and different brands of fentanyl tablets.2
*Abstral® should only be administered to patients who are considered tolerant to their opioid therapy for persistent cancer pain. Patients can be considered opioid tolerant if they take at least 60 mg of oral morphine daily, at least 25 micrograms of transdermal fentanyl per hour, at least 30 mg of oxycodone daily, at least 8 mg of oral hydromorphone daily or an equianalgesic dose of another opioid for a week or longer.1
Abstral® (fentanyl (as citrate)) is indicated for the management of breakthrough pain in adult patients using opioid therapy for chronic cancer pain. Breakthrough pain is a transient exacerbation of otherwise controlled chronic background pain. Please note not all medicines containing opioids are authorised for all types of pain indication. Refer to the summary of product characteristics before prescribing. For advice on the responsible use of opioids, including those indicated for other types of pain, please click here
1. Abstral® Summary of Product Characteristics.
2. Palliative Care Formulary 5th edition 2014.
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