fentanyl pectin nasal spray (PecFent)

Following a full submission:

fentanyl nasal spray (PecFent®) is accepted for restricted use within NHS Scotland.

Indication under review: management of breakthrough pain in adults who are already receiving maintenance opioid therapy for chronic cancer pain.

SMC restriction: restricted to use in patients unsuitable for short-acting oral opioids, as an alternative to other fentanyl preparations.

Fentanyl pectin nasal spray offers an advantage in the time to onset of pain relief and reduction in pain intensity of breakthrough pain compared with placebo and immediate release morphine sulphate. Indirect comparison indicates broadly comparable efficacy to an oral transmucosal fentanyl formulation and an existing fentanyl nasal spray.

Prescribers should be aware of the differing absorption and elimination characteristics of the available nasal fentanyl preparations; doses are not interchangeable.