Switching from Transdermal Drugs: An Observational "N of 1" Study of Fentanyl and Buprenorphine

Fabio Fulfaro, Alessandra Casuccio, Giuseppe Intravaia, Salvatore Riina, Sebastiano Mercadante, Giampiero Porzio, Corrado Ficorella, Salvatore Mangione, Federica Aielli, Lucilla Verna

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31 Citations (Scopus)


The aim of this study was to confirm that the concomitant presence oftransdermal fentanyl (TTS FE) and buprenorphine (TTS BU) may be feasiblewithout important consequences, using doses presumed to be equianalgesic. Aprospective "N of 1" study was carried out in a sample of volunteers withcancer pain receiving stable doses of TTS FE or TTS BU, with adequate painand symptom control. In the study design, each patient provided data beforeand after a switch from one opioid to the other and then back to theprevious one. Sixteen patients receiving daily stable doses of 0.6 or 1.2 mgof TTS FE were switched to TTS BU using an FE-BU ratio of 0.6-0.8. Afterthree days, the TTS BU patch was removed and TTS FE patch was placed foranother three days. Six patients receiving TTS BU were switched to TTS FEand then rotated back to TTS BU with the same dosing considerations. Nostatistical differences in changes in pain and symptom intensity duringswitching and between the two different sequences were observed. Nosignificant changes in rescue doses of oral morphine were reported at thesame intervals. Cancer patients receiving stable doses of TTS FE or TTS BUcan be safely switched to the alternative transdermal opioid. Furtherstudies should be performed to gather data about the use of TTS BU withother opioids, at different doses, and in different clinical conditions. ©2007 U.S. Cancer Pain Relief Committee.
Original languageEnglish
Pages (from-to)532-538
Number of pages7
JournalJournal of Pain and Symptom Management
Publication statusPublished - 2007

All Science Journal Classification (ASJC) codes

  • General Nursing
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

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