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The use of rotation to fentanyl in cancer-related pain

Authors Dima D, Tomuleasa C, Frinc I, Pasca S, Magdo L, Berindan-Neagoe I, Muresan M, Lisencu C, Irimie A, Zdrenghea M

Received 9 September 2016

Accepted for publication 8 November 2016

Published 9 February 2017 Volume 2017:10 Pages 341—348

DOI https://doi.org/10.2147/JPR.S121920

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Prof. Dr. Enrica Santarcangelo

Delia Dima,1 Ciprian Tomuleasa,1 Ioana Frinc,1 Sergiu Pasca,2 Lorand Magdo,2 Ioana Berindan-Neagoe,2–4 Mihai Muresan,5 Cosmin Lisencu,5 Alexandru Irimie,5,6 Mihnea Zdrenghea1,7

1Department of Hematology, Ion Chiricuta Oncology Institute, 2Faculty of Medicine, Research Center for Functional Genomics and Translational Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, Iuliu Hatieganu, 3Department of Functional Genomics, The Oncology Institute Ion Chiricuta, 4Medfuture Research Center for Advanced Medicine, University of Medicine and Pharmacy, Iuliu Hatieganu, 5Department of Surgery, Ion Chiricuta Oncology Institute, 6Department of Oncology, University of Medicine and Pharmacy, Iuliu Hatieganu, 7Department of Hematology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj Napoca, Romania


Abstract: Pain is commonly diagnosed with respect to cancer and heart diseases, being a major symptom in most neoplastic diseases. Uncontrolled pain leads to a decrease in the quality of life and an increase in the morbidity of the patient. Opioids represent the best analgetic supportive therapy and are frequently used in patients suffering from cancer and experiencing a high level of pain. Opioid treatment starts with a gradual titration of the dose until the minimum effective dose and the maximum tolerated dose are determined. Opioid rotation refers to the switch from one opioid to another in order to get a better response to analgetic therapy and reduce side effects. Fentanyl therapy is recommended to be continued during chemotherapy, radiotherapy, or in the case of surgical intervention. Rotation to fentanyl patches is an efficient and elegant solution for cancer patients, with reduced side effects. Opioid rotation, especially to fentanyl, was shown to increase the quality of life in patients with malignant disease. Finally, rotation to fentanyl is also advantageous from an economic point of view.

Keywords: opioid rotation, cancer-related pain, fentanyl

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