{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,5]],"date-time":"2026-01-05T22:14:39Z","timestamp":1767651279050,"version":"3.45.0"},"reference-count":60,"publisher":"Oncology Nursing Society (ONS)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Oncology Nursing Forum"],"published-print":{"date-parts":[[2006,1,1]]},"DOI":"10.1188\/06.onf.257-264","type":"journal-article","created":{"date-parts":[[2006,3,2]],"date-time":"2006-03-02T15:37:21Z","timestamp":1141313841000},"page":"257-264","source":"Crossref","is-referenced-by-count":6,"title":["Oral Transmucosal Fentanyl Citrate for Cancer Breakthrough Pain: A Review"],"prefix":"10.1188","volume":"33","author":[{"given":"Debra B.","family":"Gordon","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1302","published-online":{"date-parts":[[2007,1,2]]},"reference":[{"key":"E00001","unstructured":"Adelus, S., Rice, S., & Bruno, L. (2002, August). <i>Titration and evaluation of oral transmucosal fentanyl citrate (OTFC-ACTIQ) for managing breakthrough pain (BTP) in clinical practice.<\/i> Presentation at the International Conference on Cancer Nursing, London, UK."},{"key":"E00002","unstructured":"American Pain Society. (2003). <i>Principles of analgesic use in the treatment of acute pain and cancer pain<\/i> (5th ed.). Glenview, IL: Author."},{"key":"E00003","doi-asserted-by":"crossref","unstructured":"Ashburn, M.A., & Streisand, J.B. (1994). Oral transmucosal fentanyl: Help or hindrance? <i>Drug Safety, 11<\/i>, 295-300.","DOI":"10.2165\/00002018-199411050-00001"},{"key":"E00004","doi-asserted-by":"crossref","unstructured":"Ashburn, M.A., Streisand, J.B., Tarver, S.D, Mears, S.L., Mulder, S.M., Floet Wilms, A.W., et al. (1990). Oral transmucosal fentanyl citrate for premedication in paediatric outpatients. <i>Canadian Journal of Anaesthesia, 37<\/i>, 857-866.","DOI":"10.1007\/BF03006621"},{"key":"E00005","unstructured":"Ashby, M.A., Fleming, B.G., Brooksbank, M., Rounsefell, B., Runciman, W.B., Jackson, K., et al. (1992). Description of a mechanistic approach to pain management in advanced cancer. Preliminary report. <i>Pain, 52<\/i>, 153-161."},{"key":"E00006","unstructured":"Basskin, L.E. (1999). Oral transmucosal fentanyl citrate: A new dosage form for breakthrough malignant pain. <i>American Journal of Pain Management, 9<\/i>, 129-138."},{"key":"E00007","unstructured":"Bennett, D., Burton, A.W., Fishman, S., Fortner, B., McCarberg, B., Miaskowski, C., et al. (2005a). Consensus panel recommendations for the assessment and management of breakthrough pain, part 1, assessment. <i>Pharmacy and Therapeutics, 30<\/i>, 296-301."},{"key":"E00008","unstructured":"Bennett, D., Burton, A.W., Fishman, S., Fortner, B., McCarberg, B., Miaskowski, C., et al. (2005b). Consensus panel recommendations for the assessment and management of pain, part 2, management. <i>Pharmacy and Therapeutics, 30<\/i>, 354-361."},{"key":"E00009","doi-asserted-by":"crossref","unstructured":"Bruera, E., Fainsinger, R., MacEachern, T., & Hanson, J. (1992). The use of methylphenidate in patients with incident cancer pain receiving regular opiates: A preliminary report. <i>Pain, 50<\/i>, 75-77.","DOI":"10.1016\/0304-3959(92)90114-Q"},{"key":"E00010","doi-asserted-by":"crossref","unstructured":"Burton, A.W., Driver, L.C., Mendoza, T.R., & Syed, G. (2004). Oral transmucosal fentanyl citrate in the outpatient management of severe cancer pain crises: A retrospective case series. <i>Clinical Journal of Pain, 20<\/i>, 195-197.","DOI":"10.1097\/00002508-200405000-00011"},{"key":"E00011","unstructured":"Cephalon. (2004). Actiq\u00ae package insert. Frazer, PA: Author."},{"key":"E00012","unstructured":"Cephalon. (2005, May 5). Cephalon announces positive stage 3 clinical trial results for Oravescent\u00ae fentanyl. Retrieved July 21, 2005, from <a target=\"_blank\" href='http:\/\/phx.corporate-ir.net\/phoenix.zhtml?c=81709&p=irol-newsArticle&ID=706 033&highlight'>http:\/\/phx.corporate-ir.net\/phoenix.zhtml?c=81709&p=irol-newsArticle&ID=706 033&highlight<\/a>"},{"key":"E00013","doi-asserted-by":"crossref","unstructured":"Chandler, S. (1999). Oral transmucosal fentanyl citrate: A new treatment for breakthrough pain. <i>American Journal of Hospice and Palliative Care, 16<\/i>, 489-491.","DOI":"10.1177\/104990919901600213"},{"key":"E00014","doi-asserted-by":"crossref","unstructured":"Christie, J.M., Simmonds, M., Patt, R., Coluzzi, P., Busch, M.A., Nordbrock, E., et al. (1998). Dose-titration, multicenter study of oral transmucosal fentanyl citrate for the treatment for breakthrough pain in cancer patients using transdermal fentanyl for persistent pain. <i>Journal of Clinical Oncology, 16<\/i>, 3238-3245.","DOI":"10.1200\/JCO.1998.16.10.3238"},{"key":"E00015","unstructured":"Colleau, S.M. (2004). Breakthrough (episodic) vs. baseline (persistent) pain in cancer. <i>Cancer pain Release, 17<\/i>(4), 1-3."},{"key":"E00016","unstructured":"Coluzzi, P.H. (1998). Sublingual morphine: Efficacy reviewed. <i>Journal of Pain and Symptom Management, 16<\/i>, 184-192."},{"key":"E00017","doi-asserted-by":"crossref","unstructured":"Coluzzi, P.H., Schwartzberg, L., Conroy, J.D., Charapata, S., Gay, M., Busch, M.A., et al. (2001). Breakthrough cancer pain: A randomized trial comparing oral transmucosal fentanyl citrate (OTFC) and morphine sulfate immediate release (MSIR). <i>Pain, 91<\/i>, 123-130.","DOI":"10.1016\/S0304-3959(00)00427-9"},{"key":"E00018","unstructured":"Danjoux, C., Chow, E., Wong, R., Connolly, R., Andersson, L., Franssen, E., et al. (2000). Oral transmucosal fentanyl citrate (OTFC) for incidental pain in radiotherapy patients-an innovative approach [Abstract 144]. <i>Clinical Investigator Medicine, 23<\/i>(4, Suppl.), S23."},{"key":"E00019","doi-asserted-by":"crossref","unstructured":"Davis, T., Miser, A.W., Loprinzi, C.L, Kaur, J.S., Burnham, N.L., Dose, A.M., et al. (1993). Comparative morphine pharmacokinetics following sublingual, intramuscular, and oral administration in patients with cancer. <i>Hospice Journal, 9<\/i>, 85-90.","DOI":"10.1300\/J011v09n01_07"},{"key":"E00020","unstructured":"Egan, T., Kern, S.E., & Vadiei, K.Q. (2002, Feburary). <i>The pharmacokinetics and safety of oral transmucosal fentanyl administered to health volunteers as two 400-\u03bcg ACTIQ dosage units or as a single 800-\u03bcg ACTIQ dosage unit.<\/i> Poster presentation at the American Academy of Pain Management Annual Scientific Meeting, San Francisco, CA."},{"key":"E00021","doi-asserted-by":"crossref","unstructured":"Ferrante, F.M. (1996). Principles of opioid pharmacotherapy: Practical implications of basic mechanisms. <i>Journal of Pain and Symptom Management, 11<\/i>, 265-273.","DOI":"10.1016\/0885-3924(95)00201-4"},{"key":"E00022","doi-asserted-by":"crossref","unstructured":"Fine, P.G., & Busch, M.A. (1998). Characterization of breakthrough pain by hospice patients and their caregivers. <i>Journal of Pain and Symptom Management, 16<\/i>, 179-183.","DOI":"10.1016\/S0885-3924(98)00045-1"},{"key":"E00023","doi-asserted-by":"crossref","unstructured":"Fine, P.G., & Streisand, J.B. (1998). A review of oral transmucosal fentanyl citrate: Potent, rapid and noninvasive opioid analgesia. <i>Journal of Palliative Medicine, 1<\/i>, 55-63.","DOI":"10.1089\/jpm.1998.1.55"},{"key":"E00024","doi-asserted-by":"crossref","unstructured":"Foley, K.M. (1993). Opioids. <i>Neurologic Clinics, 11<\/i>, 503-522.","DOI":"10.1016\/S0733-8619(18)30135-X"},{"key":"E00025","doi-asserted-by":"crossref","unstructured":"Fortner, B.V., Okon, T.A., & Portenoy, R.K. (2002). A survey of pain-related hospitalizations, emergency department visits, and physician office visits reported by cancer patients with and without history of breakthrough pain. <i>Journal of Pain, 3<\/i>, 38-44.","DOI":"10.1054\/jpai.2002.27136"},{"key":"E00026","doi-asserted-by":"crossref","unstructured":"Gomez-Batiste, X., Madrid, F., Moreno, F., Gracia, A., Trelis, J., Nabal, M., et al. (2002). Breakthrough cancer pain: Prevalence and characteristics in patients in Catalonia, Spain. <i>Journal of Pain and Symptom Management, 24<\/i>, 45-52.","DOI":"10.1016\/S0885-3924(02)00421-9"},{"key":"E00027","doi-asserted-by":"crossref","unstructured":"Kharasch, E.D., Hoffer, C., & Whittington, D. (2004). Influence of age on the pharmacokinetics and pharmacodynamics of oral transmucosal fentanyl citrate. <i>Anesthesiology, 101<\/i>, 738-743.","DOI":"10.1097\/00000542-200409000-00023"},{"key":"E00028","doi-asserted-by":"crossref","unstructured":"Lee, M., Kern, S.E., Kisicki, J.C., & Egan, T.D. (2003). A pharmacokinetic study to compare two simultaneous 400 microg doses with a single 800 microg dose of oral transmucosal fentanyl citrate. <i>Journal of Pain and Symptom Management, 26<\/i>, 743-747.","DOI":"10.1016\/S0885-3924(03)00241-0"},{"key":"E00029","doi-asserted-by":"crossref","unstructured":"Lichtor, J.L., Sevarino, F.B., Joshi, G.P., Busch, M.A., Nordbrock, E., & Ginsberg, B. (1999). The relative potency of oral transmucosal fentanyl citrate compared with intravenous morphine in the treatment of moderate to severe postoperative pain. <i>Anesthesia and Analgesia, 89<\/i>, 732-738.","DOI":"10.1213\/00000539-199909000-00038"},{"key":"E00030","unstructured":"Lu, J., & Bailey, P.L. (2003, October). <i>Dose-related respiratory pharmacology of oral transmucosal fentanyl-citrate (OTFC) versus intravenous morphine: A randomized, double-blind, double-dummy study.<\/i> Presentation at the American Society of Anesthesiologists Annual Meeting, San Francisco, CA."},{"key":"E00031","unstructured":"Marek, B., Qazi, F., Ghazal, H., Drinkard, L., Tzou, N., Livermore, M., et al. (2001, May). Evaluation of oral transmucosal fentanyl citrate titration practices in the clinical setting. Poster abstract presented at the American Society of Clinical Oncology Annual Meeting, San Francisco, CA."},{"key":"E00032","unstructured":"Mather, E.L., & Denson, D.D. (2000). General principles of pharmacological techniques. In R.P. Raj (Ed.), <i>Practical management of pain<\/i> (3rd ed., pp. 445-461). St Louis, MO: Mosby."},{"key":"E00033","doi-asserted-by":"crossref","unstructured":"Mercadante, S., Radbruch, L., Caraceni, A., Cherny, N., Kaasa, S., Nauck, F., et al. (2002). Episodic (breakthrough) pain: Consensus conference on an expert working group of the European Association of Palliative Care. <i>Cancer, 94<\/i>, 832-839.","DOI":"10.1002\/cncr.10249"},{"key":"E00034","unstructured":"Micromedex. (2004). Morphine. Retrieved May 30, 2005, from <a target=\"_blank\" href='https:\/\/secure access.hosp.wisc.edu\/mdxdocs\/edboard.htm,DanaInfo=micromedex.hosp.wisc.edu+'>https:\/\/secure access.hosp.wisc.edu\/mdxdocs\/edboard.htm,DanaInfo=micromedex.hosp.wisc.edu+<\/a>"},{"key":"E00035","unstructured":"Mock, D.L., Streisand, J.B., Hague, B., Dzelzkalns, R.R., Bailey, P.L., Pace, N.L., et al. (1986). Transmucosal narcotic delivery: An evaluation of fentanyl (lollipop) premedication in man. <i>Anesthesia and Analgesia, 65<\/i>, S102."},{"key":"E00036","unstructured":"Moore, P.A., Cuddy, M.A., Magera, J.A., Caputo, A.C., Chen, A.H., & Wilkinson, L.A. (2000). Oral transmucosal fentanyl pretreatment for outpatient general anesthesia. <i>Anesthesia Progress, 47<\/i>(2), 29-34."},{"key":"E00037","doi-asserted-by":"crossref","unstructured":"Mystakidou, K., Katsouda, E., Parpa, E., Tsiatas, M.L., & Vlahos, L. (2005). Oral transmucosal fentanyl citrate for the treatment of breakthrough pain in cancer patients: An overview of the pharmacological and clinical characteristics. <i>American Journal of Hospice and Palliative Care, 22<\/i>, 228-232.","DOI":"10.1177\/104990910502200313"},{"key":"E00038","doi-asserted-by":"crossref","unstructured":"Nelson, P.S., Streisand, J.B., Mulder, S.M., Pace, N.L., & Stanley, T.H. (1989). Comparison of oral transmucosal fentanyl citrate and oral solutions of meperidine, diazepam, and atropine for premedication in children. <i>Anesthesiology, 70<\/i>, 616-621.","DOI":"10.1097\/00000542-198904000-00011"},{"key":"E00039","doi-asserted-by":"crossref","unstructured":"Osborne, R., Joel, S., Trew, D., & Slevin, M. (1990). Morphine and metabolite behavior after different routes of morphine administration: Demonstration of the importance of the active metabolite morphine-6-glucourinide. <i>Clinical Pharmacology and Therapeutics, 47<\/i>, 12-19.","DOI":"10.1038\/clpt.1990.2"},{"key":"E00040","doi-asserted-by":"crossref","unstructured":"Pannuti, F., Rossi, A.P., Iafelice, G., Mararo, D., Camera, P., Cricca, A., et al. (1982). Control of chronic pain in very advanced cancer patients with morphine hydrochloride administered by oral, rectal, and sublingual routes: Clinical report and preliminary results on morphine pharmacokinetics. <i>Pharmacological Research Communications, 14<\/i>, 369-380.","DOI":"10.1016\/S0031-6989(82)80107-0"},{"key":"E00041","doi-asserted-by":"crossref","unstructured":"Payne, R., Coluzzi, P., Hart, L., Simmonds, M., Lyss, A., Rauck, R., et al. (2001). Long-term safety of oral transmucosal fentanyl citrate for breakthrough cancer pain. <i>Journal of Pain and Symptom Management, 22<\/i>, 575-583.","DOI":"10.1016\/S0885-3924(01)00306-2"},{"key":"E00042","doi-asserted-by":"crossref","unstructured":"Portenoy, R.K., & Hagen, N.A. (1990). Breakthrough pain: Definition, prevalence and characteristics. <i>Pain, 41<\/i>, 273-281.","DOI":"10.1016\/0304-3959(90)90004-W"},{"key":"E00043","unstructured":"Portenoy, R.K., Lapin, J., Shaiova, L.A., Manco, L.S., Shasha, D., Hu, K., et al. (2002, May). <i>Tolerability and effects of two formulations of oral transmucosal fentanyl citrate (OTFC; ACTIQ) in patients with radiation-induced oral mucositis.<\/i> Presentation at the 38th American Society of Clinical Oncology Annual Meeting, Orlando, FL."},{"key":"E00044","doi-asserted-by":"crossref","unstructured":"Portenoy, R.K., Payne, D., & Jacobsen, P. (1999). Breakthrough pain: Characteristics and impact in patients with cancer pain. <i>Pain, 81<\/i>, 129-134.","DOI":"10.1016\/S0304-3959(99)00006-8"},{"key":"E00045","doi-asserted-by":"crossref","unstructured":"Portenoy, R.K., Payne, R., Coluzzi, P., Raschko, J.W., Lyss, A., Busch, M.A., et al. (1999). Oral transmucosal fentanyl citrate (OTFC) for the treatment of breakthrough pain in cancer patients: A controlled dose titration study. <i>Pain, 79<\/i>, 303-312.","DOI":"10.1016\/S0304-3959(98)00179-1"},{"key":"E00046","doi-asserted-by":"crossref","unstructured":"Rees, E. (2002). The role of oral transmucosal fentanyl citrate in the management of breakthrough cancer pain. <i>International Journal of Palliative Nursing, 8<\/i>, 304-308.","DOI":"10.12968\/ijpn.2002.8.6.10501"},{"key":"E00047","unstructured":"Rhiner, M., & Kedziera, P. (1999). Managing breakthrough cancer pain: A new approach. <i>American Journal of Nursing, 99<\/i>, S3-S15."},{"key":"E00048","doi-asserted-by":"crossref","unstructured":"Robison, J.M., Wilkie, D.J., & Campbell, B. (1995). Sublingual and oral morphine administration. <i>Nursing Clinics of North America, 30<\/i>, 725-743.","DOI":"10.1016\/S0029-6465(22)00117-7"},{"key":"E00049","unstructured":"Shaiova, L., Lapin, J., Manco, L.S., Shasha, D., Hu, K., Harrison, L., et al. (2004). Tolerability and effects of two formulations of oral transmucosal fentanyl citrate (OTFC; ACTIQ) in patients with radiation-induced oral mucositis. <i>Supportive Care in Cancer, 12<\/i>, 268-273."},{"key":"E00050","unstructured":"Simmonds, M.A. (1997). Oral transmucosal fentanyl citrate produces pain relief faster than medication typically used for breakthrough pain in cancer patients. <i>Proceeding from the American Society of Clinical Oncology, 16<\/i>, 52."},{"key":"E00051","doi-asserted-by":"crossref","unstructured":"Squier, C.A., & Johnson, N.W. (1975). Permeability of oral mucosa. <i>British Medical Bulletin, 31<\/i>, 169-175.","DOI":"10.1093\/oxfordjournals.bmb.a071275"},{"key":"E00052","unstructured":"Stanley, T.H., Hague, B., Mock, D.L., Streisand, J.B., Bubbers, S., Dzelzkalns, R.R., et al. (1989). Oral transmucosal fentanyl citrate (lollipop) medication in human volunteers. <i>Anesthesia and Analgesia, 69<\/i>, 21-27."},{"key":"E00053","doi-asserted-by":"crossref","unstructured":"Streisand, J.B., Busch, M.A., Egan, T.D., Smith, B.G., Gay, M., & Pace, N.L. (1998). Dose proportionality and pharmacokinetics of oral transmucosal fentanyl citrate. <i>Anesthesiology, 88<\/i>, 305-309.","DOI":"10.1097\/00000542-199802000-00006"},{"key":"E00054","unstructured":"Streisand, J.B., Busch, M.A., Gaylord, B.A., Gay, M.A., & East, K.A. (1996). Dose proportionality of oral transmucosal fentanyl citrate in human volunteers [Abstract 322]. <i>Anesthesiology, 85<\/i>(3A), 443."},{"key":"E00055","unstructured":"Streisand, J.B., Rosenberg, J.A., Ashburn, M.A., Kessler, K.F., East, K.A., Keivit, J.K., et al. (1993). Oral transmucosal fentanyl citrate: Repeated dose pharmacokinetics [Abstract 369]. <i>Anesthesiology, 79<\/i>(3A), 444."},{"key":"E00056","doi-asserted-by":"crossref","unstructured":"Streisand, J.B., Varvel, J.R., Stanski, D.R., Le Marie, L., Ashburn, M.A., Hague, B.I., et al. (1991). Absorption and bioavailability of oral transmucosal fentanyl citrate. <i>Anesthesiology, 75<\/i>, 223-229.","DOI":"10.1097\/00000542-199108000-00009"},{"key":"E00057","unstructured":"U.S. Food and Drug Administration. (1998). FDA approves ACTIQ for marketing: Drug offers cancer patients relief from breakthrough pain [FDA talk paper]. Retrieved July 21, 2005, from <a target=\"_blank\" href='http:\/\/www.fda.gov\/bbs\/topics\/ANSWERS\/ANS00921.html'>http:\/\/www.fda.gov\/bbs\/topics\/ANSWERS\/ANS00921.html<\/a>"},{"key":"E00058","doi-asserted-by":"crossref","unstructured":"Weinberg, D.S., Inturrisi, C.E., Reidenberg, B., Moulin, D.E., Nip, T.J., Wallenstein, S., et al. (1988). Sublingual absorption of selected opioid analgesics. <i>Clinical Pharmacology and Therapeutics, 44<\/i>, 335-342.","DOI":"10.1038\/clpt.1988.159"},{"key":"E00059","unstructured":"World Health Organization. (1996). <i>Cancer pain relief<\/i> (2nd ed.). Geneva, Switzerland: Author."},{"key":"E00060","doi-asserted-by":"crossref","unstructured":"Zimmer, R., & Ashburn, M.A. (2001). Noninvasive drug delivery. <i>Comprehensive Therapy, 27<\/i>, 293-301.","DOI":"10.1007\/s12019-001-0027-z"}],"container-title":["Oncology Nursing Forum"],"original-title":[],"link":[{"URL":"http:\/\/ons.metapress.com\/index\/N2871M3V75644887.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,21]],"date-time":"2025-11-21T19:51:47Z","timestamp":1763754707000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ons.org\/publications-research\/onf\/33\/2\/oral-transmucosal-fentanyl-citrate-cancer-breakthrough-pain-review"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,1,1]]},"references-count":60,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2006,1,1]]}},"alternative-id":["N2871M3V75644887"],"URL":"https:\/\/doi.org\/10.1188\/06.onf.257-264","relation":{},"ISSN":["0190-535X","1538-0688"],"issn-type":[{"type":"print","value":"0190-535X"},{"type":"electronic","value":"1538-0688"}],"subject":[],"published":{"date-parts":[[2006,1,1]]}}}