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New Medicines Profile: Fentanyl nasal spray (Instanyl®)

Publisher: South West Medicines Information and Training

Date published: 25/02/2010 09:50

Summary
by: Emma Templeman
  • Fentanyl nasal spray (Instanyl®) is licensed for breakthrough pain in adults receiving maintenance opioid therapy for chronic cancer pain. There are several other immediate release fentanyl products already on the market for this indication. Instanyl® is the first intranasal formulation available. There are two published randomised controlled trials of Instanyl®. Its use resulted in significantly superior pain reduction at 10 minutes compared to placebo, and provided analgesia around 5 minutes faster than oral transmucosal fentanyl (Actiq®).
  • The safety profile of Instanyl® appears comparable to that of other fentanyl containing products indicated in the treatment of breakthrough cancer pain. Typical opioid adverse reactions have been reported. The most common adverse reactions are somnolence, dizziness, headache, vertigo, flushing, throat irritation, hyperhidrosis, nausea and vomiting.
  • Instanyl® is currently the most expensive immediate release fentanyl preparation on the market. It is significantly more expensive than immediate release morphine.
  • As with other immediate release fentanyl products, Instanyl® treatment must be initiated and supervised by physicians experienced in opioid therapy in cancer patients.
  • Instanyl® bypasses the oral/gastrointestinal route and may offer advantages to patients with nausea or vomiting, oral mucositis, dry mouth and impaired gastrointestinal function.
NMPInstanylFeb10.pdf

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