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Breakthrough Cancer Pain

Treatment Options

Treating Cancer Pain Often Requires More Than One Type of Medication

Undertreatment of Breakthrough Cancer Pain

Many patients are instructed to manage their breakthrough pain with short-acting pain medication (e.g. morphine, oxycodone). However, those pain medications may not be ideal in treating breakthrough pain because they often have a slow onset of pain action.

Short-acting oral opioids used for treating cancer pain may not provide rapid relief for breakthrough cancer pain episodes.

Some medications requiring oral digestion and first-pass hepatic metabolism have an analgesia onset time of 30 minutes to one hour.

Breakthrough Cancer Pain Relief
Overtreatment of Breakthrough Cancer Pain

Treating breakthrough cancer pain by raising the around-the-clock medication may increase side effects such as:

  • Constipation
  • Sleepiness
  • Confusion
Treating Cancer Pain



  • Opioid non-tolerant patients: Life-threatening respiratory depression and death could occur at any dose in opioid non-tolerant patients
  • Acute or postoperative pain including headache/migraine and dental pain, or in the emergency department
  • Acute or severe bronchial asthma in an unmonitored setting or in absence of resuscitative equipment.
  • Known or suspected gastrointestinal obstruction, including paralytic ileus.
  • Known hypersensitivity (e.g., anaphylaxis) to fentanyl or components of SUBSYS
Breakthrough Cancer Pain Relief
Breakthrough Cancer Pain Relief