{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T03:28:36Z","timestamp":1760239716411,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T00:00:00Z","timestamp":1608076800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmacy"],"abstract":"<jats:p>Alfentanil is used for chronic pain relief in palliative care. However, there is a dearth of data on its use. For this reason, a decision was made to review the use of alfentanil in palliative care. Retrospective study was carried out in a palliative care service. The files of patients who received alfentanil as an intravenous or subcutaneous continuous infusion for pain relief, between January 2018 and April 2019. In total, 111 patients received alfentanil out of 113 admissions. Of them, 56 were male, and the median age was 70 years. The median number of days on alfentanil was 6 (range 1 to 129). The most frequent primary reasons for switching to alfentanil was uncontrolled pain in 52 (46%) patients and renal impairment in 24 (21%) patients. The median 24-h initial dose of alfentanil was 4 mg (1\u201320), and the median final 24-h dose of alfentanil was 5 mg (1\u201360), (p &lt; 0.001). The initial 24-h median number of rescue doses was 2 (0\u20138), and the final median number of rescue doses was 1 (0 to 8), (p = 0.025). In 56 patients who were on alfentanil for at least 7 days, the dose decreased in 3 (5%), remained stable in 10 (18%) and increased in 43 (77%). The patient on alfentanil for 129 days maintained the same dose throughout that period. Alfentanil can be a useful second-line opioid. The induction of tolerance does not seem to be particularly rapid with alfentanil.<\/jats:p>","DOI":"10.3390\/pharmacy8040240","type":"journal-article","created":{"date-parts":[[2020,12,16]],"date-time":"2020-12-16T09:21:15Z","timestamp":1608110475000},"page":"240","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Use of Alfentanil in Palliative Care"],"prefix":"10.3390","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9506-7106","authenticated-orcid":false,"given":"Jos\u00e9 Ant\u00f3nio","family":"Ferraz Gon\u00e7alves","sequence":"first","affiliation":[{"name":"Servi\u00e7o de Cuidados Paliativos, Instituto Portugu\u00eas de Oncologia, 4200-072 Porto, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5770-6042","authenticated-orcid":false,"given":"Filipa","family":"Sousa","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Medicina Interna, Centro Hospitalar Tondela Viseu, 3504-509 Viseu, Portugal"}]},{"given":"Lucy","family":"Alves","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Oncologia M\u00e9dica, Centro Hospitalar Universit\u00e1rio do Algarve, 8000-386 Faro, Portugal"}]},{"given":"Patr\u00edcia","family":"Liu","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Oncologia M\u00e9dica, Centro Hospitalar de Tr\u00e1s-os-Montes e Alto Douro, 5000-508 Vila Real, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5111-5543","authenticated-orcid":false,"given":"Sara","family":"Coelho","sequence":"additional","affiliation":[{"name":"Servi\u00e7o de Oncologia M\u00e9dica, Instituto Portugu\u00eas de Oncologia, 4200-072 Porto, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,16]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (1996). Cancer Pain Relief, World Health Organization. [2nd ed.]. Available online: https:\/\/apps.who.int\/iris\/bitstream\/handle\/10665\/37896\/9241544821.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.2147\/JPR.S170269","article-title":"Practical management of opioid rotation and equianalgesia","volume":"11","author":"Treillet","year":"2018","journal-title":"J. Pain Res."},{"key":"ref_3","first-page":"335","article-title":"Alfentanil in Anesthesia and Analgesia","volume":"20","author":"Reitz","year":"1986","journal-title":"Drug Intell. Clin. Pharm."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1451","DOI":"10.1016\/j.ajem.2017.04.041","article-title":"Randomized clinical trial of propofol versus alfentanil for moderate procedural sedation in the emergency department","volume":"35","author":"Miner","year":"2017","journal-title":"Am. J. Emerg. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1191\/0269216304pm910oa","article-title":"A retrospective review of the use of alfentanil in a hospital palliative care setting","volume":"18","author":"Urch","year":"2004","journal-title":"Palliat. Med."},{"key":"ref_6","unstructured":"Janssen (2019, December 17). Rapifen\u00ae Injection Product Information. 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Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1136\/bmjspcare-2017-001349","article-title":"Opioid rotation to alfentanil: Comparative evaluation of conversion ratios","volume":"7","author":"Cran","year":"2017","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"681","DOI":"10.2165\/00003088-200746080-00005","article-title":"General Framework for the Quantitative Prediction of CYP3A4-Mediated Oral Drug Interactions Based on the AUC Increase by Coadministration of Standard Drugs","volume":"46","author":"Ohno","year":"2007","journal-title":"Clin. Pharmacokinet."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1213\/00000539-200007000-00021","article-title":"Acute tolerance to continuously infused alfentanil: The role of Cholecystokinin and N-Methyl-D-Aspartate-Nitric Oxide Systems","volume":"91","author":"Kissin","year":"2000","journal-title":"Anesth. Analg."}],"container-title":["Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2226-4787\/8\/4\/240\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:45:57Z","timestamp":1760179557000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2226-4787\/8\/4\/240"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,16]]},"references-count":12,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["pharmacy8040240"],"URL":"https:\/\/doi.org\/10.3390\/pharmacy8040240","relation":{},"ISSN":["2226-4787"],"issn-type":[{"type":"electronic","value":"2226-4787"}],"subject":[],"published":{"date-parts":[[2020,12,16]]}}}