Fentora

Treatment of breakthrough pain episodes in adult patients with cancer who are already on a regular around-the-clock opioid regimen for persistent cancer-related pain. It is only indicated for patients considered opioid-tolerant, meaning they have been taking doses equivalent to at least 60 mg of oral morphine daily for a week or longer.

Fentora contains fentanyl, a potent synthetic opioid agonist that binds primarily to mu-opioid receptors in the brain and nervous system. The buccal formulation allows fentanyl to be absorbed through the oral mucosa directly into the bloodstream, providing relatively rapid onset of pain relief typically within 10-15 minutes. Its effects are similar to other opioid analgesics, producing analgesia, sedation, and respiratory depression.

Fentora carries a black box warning for risk of addiction, abuse, misuse, and potentially fatal respiratory depression. It should never be used for acute or postoperative pain or in opioid-naive patients. Accidental exposure, particularly in children, can be fatal. The medication must be stored securely out of reach of others, and patients should follow strict dosing guidelines without altering tablets or using them more frequently than prescribed. Patients should also avoid grapefruit juice and certain medications that interact with CYP3A4 enzymes.