Document Detail


Direct conversion from oral morphine to transdermal fentanyl: a multicenter study in patients with cancer pain.
MedLine Citation:
PMID:  8783318     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Direct conversion from oral morphine to transdermal fentanyl with a ratio of oral morphine/transdermal fentanyl (100:1 mg) daily was examined in patients with cancer pain. Patients with a 'stable and low level of cancer pain' receiving a constant dosage of sustained release morphine during a pre-study phase of 6 days were included in the study. Initial fentanyl dosage was calculated by a conversion table. The transdermal system was changed every 72 h and the dosage was adjusted to the needs of the patients according to the VAS scores and the requirement of liquid morphine, which was allowed to achieve sufficient pain relief. Regression analysis at the end of the study revealed a mean morphine/transdermal fentanyl ratio of 70:1. Pain relief during treatment with transdermal fentanyl was identical to sustained release morphine. However, significantly more patients took supplemental medication with liquid morphine during transdermal fentanyl therapy. The number of patients suffering from pain attacks did not increase with transdermal fentanyl. Constipation and medication with laxatives decreased significantly during fentanyl therapy. Other side effects and vital signs were identical. Three patients suffered from a morphine withdrawal syndrome beginning within the first 24 h of transdermal fentanyl therapy. Cutaneous reactions to the patch were rare, mild and transient. Patients and physicians reported satisfaction with the transdermal therapy. 94.7% of the patients chose to continue the transdermal fentanyl therapy at the end of the study due to better performance in comparison to oral morphine. Due to these results an initial conversion from oral morphine to transdermal fentanyl with the ratio of 100:1 is safe and effective.
Authors:
B Donner; M Zenz; M Tryba; M Strumpf
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Publication Detail:
Type:  Clinical Trial; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pain     Volume:  64     ISSN:  0304-3959     ISO Abbreviation:  Pain     Publication Date:  1996 Mar 
Date Detail:
Created Date:  1996-12-05     Completed Date:  1996-12-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7508686     Medline TA:  Pain     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  527-34     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, University Hospital Bergmannsheil, Bochum, Germany.
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MeSH Terms
Descriptor/Qualifier:
Administration, Cutaneous
Adult
Aged
Analgesics, Opioid / administration & dosage,  adverse effects,  therapeutic use*
Female
Fentanyl / administration & dosage,  adverse effects,  therapeutic use*
Humans
Male
Middle Aged
Morphine / administration & dosage,  adverse effects,  therapeutic use*
Neoplasms / complications*
Pain / drug therapy*,  etiology
Pain Measurement
Regression Analysis
Chemical
Reg. No./Substance:
0/Analgesics, Opioid; 437-38-7/Fentanyl; 57-27-2/Morphine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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