Re: Fentora?

On Wed, 19 Sep 2007 18:25:10 GMT, Mike Berkowitz
<mkberk@xxxxxxxxxxxxxxxxxxxxxxxxxxxxxx> wrote:

Anyone here have experience with this fentanyl based pain medication.
The news media is promoting the deaths associated with headache
patients as proof that the drug should ONLY be prescribed for cancer
patients. (Everyone knows cancer patients are immune to overdoses.
Besides they have cancer and might die anyway [this is said as
sarcasm] ).

I am not allowed Actiq because the insurance company uses the FDA
approval criteria to limit its availability as part of a formulary
restriction. Approval is contingent upon the drug being administered
to cancer patients by a pain specialist after other pain medications
prove ineffective. Even then there is a monthly limit. (Yes, I know it
has more to do with the cost than their concern for my safety.)

I see this as a way to pressure pain specialists to follow FDA
approval criteria when prescribing pain medications to their patients
or risk disciplinary action.

Anyway, I am interested in hearing if fentora is an effective way to
deliver fentanyl and if it works as well as patches do. I am not
talking about comparing IR vs ER effects just overall pain killing
properties of Fentanyl. Is it cheaper than Actiq?


Mike


It is not only the news media as the Fact *** published by Cephalon
states *cancer pain* only. Also, the FDA New Drug Application and
Approval Letter also state *breakthrough pain in opioid-tolerant
patients with cancer*. Further, the Package Insert indicates only
cancer pain.
http://www.opioids.com/fentanyl/fentanyl-fentora.pdf

Whether it is Duragesic (Patch), Actiq (lollipop) or Fentora (lozenge)
the drug itself is the same - fentanyl citrate.
Duragesic delivery is transdermal while both Actiq and Fentora are
delivered through oral buccal mucosa.
Personally, I know of only one person who has used fentanyl. He passed
away in July from cancer. However, from my reading I recall that
Fentora provides more efficient absorption and quicker onset of action
than Actiq. I looked but cannot find that article now but if I do find
it I'll post a link for you. Of course transdermal is very slow
compared to the oral versions.
The stuff is so amazingly potent that 250ug (an incredibly tiny
amount) is considered the minimum lethal dose.

.