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Plasma concentrations of fentanyl were measured by g.c. in 20 patients (median age: 75 years and range: 54-86 years; eight females) in palliative care receiving the drug by continuous s.c. infusion (median rate: 1200 micrograms day-1 and range: 100-5000 micrograms day-1). 2. The infusion rate was significantly related to the duration of therapy (Spearman rho = 0.56, P < 0.05). The total steady-state plasma concentrations of fentanyl ranged between 0.1 and 9 ng ml-1, with a median of 1 ng ml-1. The unbound fraction of fentanyl in the plasma ranged from 17.8 to 44.4%, with a median value of 33.6%. Infusion rates and both total and unbound plasma concentrations of fentanyl were correlated (Spearman rho = 0.92, P < 0.05 in each case). Even with standardization for dosage, there was an eightfold variation in total plasma concentrations and 3.5-fold variation in unbound plasma concentrations of fentanyl. 3. There is considerable inter-patient variability in the pharmacokinetics of fentanyl with s.c. infusion in the palliative care setting, which necessitates careful titration of dosage according to individual clinical response.

Item Type:	Refereed Article
Research Division:	Medical and Health Sciences
Research Group:	Pharmacology and Pharmaceutical Sciences
Research Field:	Clinical Pharmacology and Therapeutics
Objective Division:	Health
Objective Group:	Other Health
Objective Field:	Health not elsewhere classified
Author:	Miller, RS (Mrs Rachel Susan Miller)
Author:	Peterson, GM (Professor Gregory Peterson)
Author:	McLean, SR (Professor Stuart McLean)
ID Code:	5377
Year Published:	1995
Web of Science® Times Cited:	12
Deposited By:	Pharmacy
Deposited On:	1995-08-01
Last Modified:	2011-06-02
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