Abstral is a sublingual tablet formulation of fentanyl citrate, a potent opioid analgesic. The precise mechanism of the analgesic action is unknown.
Abstral is specifically indicated for the management of breakthrough pain in cancer patients 18 years of age and older who are already receiving, and who are tolerant to, opioid therapy for their underlying persistent cancer pain.
Abstral is supplied as a sublingual tablet designed for oral administration. The recommended initial dose of the drug is a single 100 mcg tablet. If adequate analgesia is obtained within 30 minutes of administration of the 100 mcg tablet, continue to treat subsequent episodes of breakthrough pain with this dose. If adequate analgesia is not obtained after the initial dose, the patient may use a second Abstral dose (after 30 minutes) as directed by their health care provider. No more than two doses of Abstral may be used to treat an episode of breakthrough pain. Patients must wait at least 2 hours before treating another episode of breakthrough pain. The Abstral dose should be escalated in a stepwise manner, increased by 100 mcg multiples up to 400 mcg, over consecutive breakthrough episodes until adequate analgesia with tolerable side effects is achieved.
Adverse events associated with the use of Abstral may include, but are not limited to, the following:
Mechanism of Action
Abstral is a sublingual tablet formulation of fentanyl citrate, a potent opioid analgesic. The precise mechanism of the analgesic action is unknown although fentanyl is known to be a µ-opioid receptor agonist. Specific CNS opioid receptors for endogenous compounds with opioid-like activity have been identified throughout the brain and spinal cord and play a role in the analgesic effects of this drug.