Fentanyl Nasal Spray Now Available at a Dose of 300 µg for Treatment of Breakthrough Cancer Pain


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Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-µg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for patients, effectively managing breakthrough cancer pain.

The product is the only U.S. Food and Drug Administration–approved transmucosal immediate release fentanyl that is nasally delivered, providing rapid relief of breakthrough cancer pain in adults. It is a fast-acting option for patients who struggle with or cannot swallow due to nausea, or who experience vomiting or oral complications such as mucositis, ulcers, and dry mouth. It is indicated for treatment of breakthrough cancer pain in adults already receiving opioid therapy for their underlying persistent cancer pain.

Flexibility in Pain Management

Steven Wong, MD

Steven Wong, MD

“[Breakthrough cancer pain] is often debilitating and intense, arising spontaneously multiple times throughout the day. It affects quality of life for many cancer patients, who may not know that the pain can be successfully managed,” said Steven Wong, MD, medical oncologist/hematologist and former Associate Professor of Medicine and Urology at the David Geffen School of Medicine at the University of California, Los Angeles. “As physicians, it is imperative that we have the options and flexibility to effectively and safely manage this severe pain for our patients.”

Fentanyl nasal spray is a nonirritating, fine mist that provides pain relief for patients within minutes and lasts at least an hour. It is now available in three dosing strengths, with each spray delivering 100 µL of solution containing a 100, 300, or 400-µg fentanyl base. It can now be titrated to 200, 300, 400, 600 or 800 µg if adequate pain relief is not achieved with the starting dose, which is 100 µg for all patients. ■



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