Personalizing Analgesic Selection for Breakthrough Pain

The pharmacokinetics are similar between the varying transmucosal immediate-release fentanyl (TIRF) products, making treatment selection difficult in terms of efficacy. As a result, the optimal therapy to administer should be tailored based on patient characteristics, notes Marc Rappaport, DO.

If a patient has mucositis, sublingual TIRF products are better tolerated than fentanyl nasal sprays, which adhere directly to the mucosa. Rappaport recommends developing familiarity with several of the available TIRF products, in order to be able to personalize the treatment decision.