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Plasma concentrations of fentanyl with subcutaneous infusion in palliative care patients
journal contributionposted on 2023-05-16, 09:51 authored by Miller, RS, Gregory PetersonGregory Peterson, Abbott, F, Maddocks, I, Parker, D, Stuart McLeanStuart McLean
Plasma concentrations of fentanyl were measured by g.c. in 20 patients (median age: 75 years and range: 54-86 years; eight females) in palliative care receiving the drug by continuous s.c. infusion (median rate: 1200 micrograms day-1 and range: 100-5000 micrograms day-1). 2. The infusion rate was significantly related to the duration of therapy (Spearman rho = 0.56, P < 0.05). The total steady-state plasma concentrations of fentanyl ranged between 0.1 and 9 ng ml-1, with a median of 1 ng ml-1. The unbound fraction of fentanyl in the plasma ranged from 17.8 to 44.4%, with a median value of 33.6%. Infusion rates and both total and unbound plasma concentrations of fentanyl were correlated (Spearman rho = 0.92, P < 0.05 in each case). Even with standardization for dosage, there was an eightfold variation in total plasma concentrations and 3.5-fold variation in unbound plasma concentrations of fentanyl. 3. There is considerable inter-patient variability in the pharmacokinetics of fentanyl with s.c. infusion in the palliative care setting, which necessitates careful titration of dosage according to individual clinical response.
Publication titleBritish Journal of Clinical Pharmacology
Pagination553 - 556
Department/SchoolSchool of Pharmacy and Pharmacology
PublisherWiley-Blackwell Publishing Ltd.
Place of publicationUK
Rights statementThe definitive published version is available online at: http://onlinelibrary.wiley.com/