| buccal tablet (Fentora®, generic) |
100 mcg, 200 mcg, 400 mcg, 600 mcg, or 800 mcg per tablet |
800 mcg/dose; no more than 4 tablets at one time per breakthrough episode, and no more than 2 doses per breakthrough pain episode; if more than 4 breakthrough episodes per 24 hours occur once maintenance dose determined, long-acting opioid dose should be re-evaluated |
| intranasal spray (Lazanda®) |
100 mcg, 300 mcg, or 400 mcg per actuation |
800 mcg/dose; if more than 4 breakthrough episodes per 24 hours occur once maintenance dose determined, long-acting opioid dose should be re-evaluated |
| sublingual tablet (Abstral®) |
100 mcg, 200 mcg, 300 mcg, 400 mcg, 600 mcg, or 800 mcg per tablet |
800 mcg/dose; no more than 4 tablets at one time per breakthrough episode, and no more than 2 doses per breakthrough pain episode; if more than 4 breakthrough episodes per 24 hours occur once maintenance dose determined, long-acting opioid dose should be re-evaluated |
| sublingual spray (Subsys®) |
100 mcg, 200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, or 1600 mcg per spray |
1600 mcg/dose; no more than 2 doses per breakthrough pain episode; if more than 4 breakthrough episodes per 24 hours occur once maintenance dose determined, long-acting opioid dose should be re-evaluated |
| transmucosal lozenge (Actiq®, generic) |
200 mcg, 400 mcg, 600 mcg, 800 mcg, 1200 mcg, or 1600 mcg per lozenge |
no more than 2 units/lozenges per breakthrough pain episode; no more than 4 lozenge units/day; if more than 4 breakthrough episodes per 24 hours occur once maintenance dose determined, long-acting opioid dose should be re-evaluated |
| transdermal patch (Duragesic®, generic) |
12 mcg/hr, 25 mcg/hr, 37.5 mcg/hr, 50 mcg/hr, 75 mcg/hr, 100 mcg/hr |
maximum dose not identified; dosages titrated every 3 days after initial dose, then every 6 days thereafter; most patients controlled with every 72 hour administration; a small percentage require every 48 hour administration |
