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DAR No 5: Intranasal fentanyl (Instanyl®) in breakthrough pain
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A different route of administration with no advantages regarding efficacy or safety
- Intranasal fentanyl represents an alternative route for the administration of opioids, although it does not improve the safety profile.
- It acts slightly earlier than transmucosal oral fentanyl but presents twice the amount of failures in breakthrough pain control.
- Possible risks of overdose have been highlighted as well as the potential danger for children and the family, given the nasal spray device.
- There is a risk of confusion regarding doses with other presentations of fentanyl, especially with PecFent® when administering doses of 100 μg: NEVER carry out a dosefor- dose change in medication (microgram-for-microgram).
- It can be an alternative in patients with oral intolerance.
