A recent study of a fentanyl sublingual spray known as Subsys has found that the drug can improve pain management for patients with cancer pain. However, because of the way the medication is delivered to the body, Subsys may create unique risks that could place some patients at risk of a fentanyl overdose.
Subsys is a sublingual spray containing the powerful opioid painkiller fentanyl. Subsys was approved by the Food and Drug Administration in January 2012 for the treatment of breakthrough cancer pain. The drug is delivered to the body by being sprayed under the tongue, from which it is absorbed into the bloodstream.
Researchers at the University of New York found that Subsys was effective at treating patients with breakthrough cancer pain and improving quality of life. However, because of the extreme potency of the medication and the way it is delivered to the body, the fentanyl spray could be extremely dangerous.
Because fentanyl is about 100 times more potent than morphine, taking even a small amount of the drug can lead to a fatal overdose. Experts have advised patients who are prescribed the Subsys fentanyl spray to start with only one spray of the drug in order to ensure that too much is not taken.
Fentanyl is only intended for use by patients who have already been treated with other painkiller medications and who have become opioid tolerant as a result. Prescribing Subsys to patients who are not opioid tolerant could also lead to an overdose because these patients are not able to tolerate the extreme potency of fentanyl. Doctors must exercise caution in prescribing fentanyl medications such as Subsys in order to prevent overdoses among patients who should not be taking this drug.