Buy 200 mcg Abstral sublingual tablet online
|32 (8 x 4 each)||$63.04||$2,017.41|
Abstral Sublingual Tablet Indications and Use
ABSTRAL® is for the treatment of breakthrough pain in cancer patients aged 18 and up who are currently receiving and tolerating round-the-clock opioid medication for their underlying persistent cancer pain. Buy 200 mcg Abstral sublingual tablet online
Patients who take at least 60 mg oral morphine per day, or at least 25 mcg transdermal fentanyl per hour, or at least 30 mg oral oxycodone per day, or at least 8 mg oral hydromorphone per day, or at least 25 mg oral oxymorphone per day, or at least 60 mg oral hydromorphone per day, or an equianalgesic dose of another opioid medication daily for a week or longer are considered opioid tolerant. When using ABSTRAL®, patients must be on opioids 24 hours a day, seven days a week.
Not to be used in those who aren’t tolerant to opioids.
Not to be used in the treatment of acute or postoperative pain, including headaches/migraines, dental pain, or in the emergency room [see Contraindications (4)].
ABSTRAL is exclusively available to outpatients who are engaged in the TIRF REMS Access program [see Warnings and Precautions (5.7)]. Patient and prescriber enrollment is not necessary for inpatient administration of ABSTRAL (e.g., hospitals, hospices, and long-term care facilities that prescribe for inpatient use).
Dosage and Administration of Abstral Sublingual Tablets
To guarantee safe use of ABSTRAL, healthcare practitioners who prescribe it on an outpatient basis must join in the TIRF REMS Access program and follow the REMS’ requirements.
Use the smallest effective dose for the shortest time in accordance with the therapeutic goals of each individual patient.
To avoid confusion and possible overdose, keep the number of strengths offered to patients to a minimum at all times.
Start the dose regimen for each patient separately, taking into account the patient’s pain severity, responsiveness, previous analgesic treatment history, and risk factors for addiction, abuse, and misuse.
Monitor patients for respiratory depression, especially in the first 24-72 hours after starting medication and after increasing the dosage of ABSTRAL; modify the dosage as needed.
Other fentanyl compounds are not bioequivalent to ABSTRAL. Do not convert patients from other fentanyl medications mcg for mcg. Other than ACTIQ, there are no conversion instructions available for patients on other fentanyl medications. (Note: This includes fentanyl formulations that are used orally, transdermally, or parenterally.)
Converting from ACTIQ to ABSTRAL
Prescribers must utilize the Initial Dosing Recommendations for Patients on ACTIQ while converting patients from ACTIQ. Initial dose recommendations can be seen in Table 1. Patients must be told to discontinue taking ACTIQ and throw away any remaining units.Buy 200 mcg Abstral sublingual tablet online
|Current ACTIQ Dose (mcg)||Initial ABSTRAL Dose (mcg)|
Titrate with 100 mcg and 200 mcg of ABSTRAL, respectively, for patients converting from ACTIQ dosages of 200 mcg and 400 mcg, and thereafter use multiples of this strength.
Patients switching from ACTIQ doses of 600 and 800 mcg should begin titration with 200 mcg of ABSTRAL and work their way up in strength.
Titrate with 200 mcg and 400 mcg of ABSTRAL, respectively, for patients converting from ACTIQ dosages of 1200 and 1600 mcg, and thereafter use multiples of this level.
Therapy titration and maintenance
The goal of dosage titration is to find a maintenance dose that is both effective and tolerable. Using a single ABSTRAL dosage unit every breakthrough cancer pain episode, continuously monitor patients and gradually increase dosage strength until they reach a dose that gives appropriate analgesia. If evidence of excessive opioid effects develop before the unit is finished, the dosage unit should be taken from the patient’s mouth as soon as possible, appropriately disposed of, and subsequent dosages reduced. Patients should keep track of their ABSTRAL use throughout numerous bouts of breakthrough cancer pain and discuss their findings with their doctors to see if a dosage change is necessary for breakthrough cancer pain management. ABSTRAL’s effective and acceptable dose will be determined by dose titration in individual patients.
If appropriate analgesia is not reached with the first 100 mcg dose, gradually increase the dose over subsequent breakthrough episodes until adequate analgesia is achieved with tolerable side effects. As needed, increase the dose by 100 mcg increments up to 400 mcg. If a 400 mcg dose does not provide enough analgesia, the following titration step is 600 mcg. If a 600 mcg dose does not provide enough analgesia, the following titration step is 800 mcg. Patients can be told to take multiples of 100 mcg and/or 200 mcg tablets for any single dosage during titration. Patients should not take more than four tablets at a time. If enough analgesia is not obtained within 30 minutes of administration,
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