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Like many analgesics, transmucosal immediate-release fentanyl (TIRF) products can be associated with adverse events. Concerns over these unintended consequences are often enhanced when treating breakthrough cancer pain, since patients with cancer can be frail and are often elderly, notes Vitaly Gordin, MD.
For patients taking TIRF products, the main concerns are excessive sedation with respiratory suppression and constipation. Additionally, patients could be unstable when taking analgesics, resulting in falls and fractures. These concerns should be weighed when determining the appropriate dose, Gordin notes.
In general, TIRF products should be stored in a lock box and kept away from children and pets, notes Jeri L. Ashley, RN. Additionally, patients should avoid driving while using analgesics.