Fentanyl pectin nasal spray (PecFent®) uses a novel
pectin-based delivery system that turns from an aqueous
solution into a gel when applied to mucosal surfaces.
Fentanyl is absorbed in a controlled manner from the
pectin gel formed in the nasal cavity, and has a rapid onset of
pain relief and duration of action that matches the time course of a typical episode of
breakthrough pain in
cancer (BTPc). Relative to administration as oral transmucosal
fentanyl,
fentanyl administered as
fentanyl pectin nasal spray is more rapidly absorbed, reaches higher maximum plasma concentrations and has greater bioavailability. In the treatment of BTPc in two randomized, double-blind, crossover trials in
opioid-tolerant adults,
fentanyl pectin nasal spray (100-800 μg titrated doses) was significantly more effective than placebo in reducing
pain intensity and provided a significantly faster onset of
pain relief than oral immediate-release
morphine. During long-term treatment of BTPc episodes,
fentanyl pectin nasal spray consistently provided effective
pain relief in an open-label, 16-week trial. Most patients were satisfied or very satisfied with the ease of use and convenience of the
nasal spray.
Fentanyl pectin nasal spray 100-800 μg was generally well tolerated and was not associated with nasal tolerability problems.