Pain management can be a serious health issue for cancer patients, separate and apart from their underlying cancer, according to the National Institutes of Health. Finding an effective treatment for these patients can be harrowing. Many are put on opioids, drugs that decrease one’s perception of and reaction to pain, as well as increase one’s pain tolerance.

Studies suggest that as many as two-thirds of patients with chronic pain from cancer who receive around-the-clock opioids develop a tolerance to opioids and experience intermittent pain that breaks through their medication. To treat these episodes of breakthrough pain, drug companies have introduced powerful narcotics, such as Cephalon’s Actiq (fentanyl citrate) and the more potent opioid, Fentora.

In 2006, Actiq became open for generics, paving the way for drug companies like Coviden to introduce its Fentanyl Citrate to the distributors. Both Actiq and its generic version are lollypop lozenges that are administered orally.

Fentanyl citrate is only indicated for the management of breakthrough pain in cancer patients who are already receiving and are tolerant to around-the-clock opioid therapy for their cancer-related pain. Patients who have not already developed a tolerance to the drug are at risk of life-threatening respiratory depression. Yet, as many as 90 percent of prescriptions for the drug are written for the off-label treatment of migraines and backaches.

To date, 127 deaths and 91 incidents of severe side effects have been associated with use of fentanyl citrate.

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