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Last Updated: February 7, 2025

CLINICAL TRIALS PROFILE FOR FENTANYL-12


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505(b)(2) Clinical Trials for Fentanyl-12

This table shows clinical trials for potential 505(b)(2) applications. See the next table for all clinical trials
Trial Type Trial ID Title Status Sponsor Phase Start Date Summary
New Combination NCT00620828 ↗ The Role of Intra-Operative Intracapsular Blocks in Post-Operative Pain Management Following Total Knee Arthroplasty Completed Pfizer Phase 4 2007-05-01 The purpose of this study is to use a new combination of anesthesia techniques in an attempt to minimize early pain after surgery and improve the patient's ability to participate more fully with physical therapy. Total knee replacement patients who participate will receive the standard anesthesia. This includes a spinal nerve block as well as a femoral nerve block. The study is looking at the added benefits of including an injection of numbing medication (Bupivicaine) to the back of the knee. This injection occurs during surgery. In order to compare the outcomes we will also have a group of patients who will receive a saline injection as opposed to the numbing medication. Patients are randomly assigned to a group. Outcomes are measured up until twenty-four hours following the surgery.
New Combination NCT00620828 ↗ The Role of Intra-Operative Intracapsular Blocks in Post-Operative Pain Management Following Total Knee Arthroplasty Completed Duke University Phase 4 2007-05-01 The purpose of this study is to use a new combination of anesthesia techniques in an attempt to minimize early pain after surgery and improve the patient's ability to participate more fully with physical therapy. Total knee replacement patients who participate will receive the standard anesthesia. This includes a spinal nerve block as well as a femoral nerve block. The study is looking at the added benefits of including an injection of numbing medication (Bupivicaine) to the back of the knee. This injection occurs during surgery. In order to compare the outcomes we will also have a group of patients who will receive a saline injection as opposed to the numbing medication. Patients are randomly assigned to a group. Outcomes are measured up until twenty-four hours following the surgery.
New Formulation NCT01349140 ↗ EXPAREL Dose-Response for Single-Injection Femoral Nerve Blocks Completed Pacira Pharmaceuticals, Inc Phase 1 2012-02-01 EXPARELâ„¢, an investigational drug product, is a new formulation of a local anesthetic (numbing medicine) that is designed to be longer acting than the currently-available local anesthetics. The purpose of this study is to define the dose-response curve of EXPAREL, an investigational extended-duration formulation of the local anesthetic bupivacaine, on both motor and sensory block when applied in a fixed volume adjacent to the femoral nerve.
New Formulation NCT01349140 ↗ EXPAREL Dose-Response for Single-Injection Femoral Nerve Blocks Completed University of California, San Diego Phase 1 2012-02-01 EXPARELâ„¢, an investigational drug product, is a new formulation of a local anesthetic (numbing medicine) that is designed to be longer acting than the currently-available local anesthetics. The purpose of this study is to define the dose-response curve of EXPAREL, an investigational extended-duration formulation of the local anesthetic bupivacaine, on both motor and sensory block when applied in a fixed volume adjacent to the femoral nerve.
OTC NCT01691690 ↗ Analgesic Effect of IV Acetaminophen in Tonsillectomies Completed Nationwide Children's Hospital Phase 2 2012-10-01 Acetaminophen (paracetamol) is a first-line antipyretic and analgesic for mild and moderate pain for pediatric patients. Its common use (particularly in oral form) is underscored by its wide therapeutic window, safety profile, over the counter accessibility, lack of adverse systemic effects (as compared with NSAIDS and opioids) when given in appropriate doses. Although the exact anti-nociceptive mechanisms of acetaminophen continue to be elucidated, these mechanisms appear to be multi-factorial and include central inhibition of the cyclo-oxygenase (COX) enzyme leading to decreased production of prostaglandins from arachidonic acid, interference with serotonergic descending pain pathways, indirect activation of cannabinoid 1 (CB1) receptors and inhibition of nitric oxide pathways through N-methyl-D-aspartate (NMDA) or substance P. Of the above mechanisms, the most commonly known is that of central inhibition of COX enzymes by which the decreased production of prostaglandins diminish the release of excitatory transmitters of substance P and glutamate which are both involved in nociceptive transmission (Anderson, 2008; Smith, 2011). To date, several studies have shown acetaminophen's opioid sparing effect in the pediatric population when given by the rectal or intravenous routes (Korpela et al, 1999; Dashti et al, 2009; Hong et al, 2010).
>Trial Type >Trial ID >Title >Status >Phase >Start Date >Summary

All Clinical Trials for Fentanyl-12

Trial ID Title Status Sponsor Phase Start Date Summary
NCT00000273 ↗ A Laboratory Model for Heroin Abuse Medications - 8 Completed National Institute on Drug Abuse (NIDA) Phase 2 1995-08-01 The purpose of this study is to evaluate the effects of treatment medications (methadone, buprenorphine, LAAM, naltrexone, naltrexone microcapsules, and methoclocinnamox) on I.V. and smoked heroin self-administration."
NCT00000273 ↗ A Laboratory Model for Heroin Abuse Medications - 8 Completed New York State Psychiatric Institute Phase 2 1995-08-01 The purpose of this study is to evaluate the effects of treatment medications (methadone, buprenorphine, LAAM, naltrexone, naltrexone microcapsules, and methoclocinnamox) on I.V. and smoked heroin self-administration."
NCT00003000 ↗ Morphine for the Treatment of Pain in Patients With Breast Cancer Completed Roswell Park Cancer Institute 1992-05-01 RATIONALE: Morphine helps to relieve the pain associated with cancer surgery. Giving morphine in different ways may offer more pain relief. PURPOSE: This randomized clinical trial is studying how well morphine injected directly into the underarm area works compared with morphine injected into the back of the shoulder in treating pain in patients who have breast cancer and who are undergoing axillary lymph node dissection.
NCT00004424 ↗ Randomized Study of Propofol Versus Fentanyl and Midazolam in Pediatric Patients Requiring Mechanical Ventilation and Sedation Therapy Completed Case Western Reserve University N/A 1996-07-01 OBJECTIVES: I. Assess the degree of amnesia afforded by study sedatives relative to the patient's intensive care unit experiences. II. Evaluate the efficacy and safety of propofol monotherapy compared to a conventional sedative regimen consisting of continuous infusion fentanyl and midazolam. III. Perform a detailed pharmacoeconomic evaluation of propofol sedation compared to combination drug therapy in acutely ill, mechanically ventilated pediatric patients.
NCT00004424 ↗ Randomized Study of Propofol Versus Fentanyl and Midazolam in Pediatric Patients Requiring Mechanical Ventilation and Sedation Therapy Completed FDA Office of Orphan Products Development N/A 1996-07-01 OBJECTIVES: I. Assess the degree of amnesia afforded by study sedatives relative to the patient's intensive care unit experiences. II. Evaluate the efficacy and safety of propofol monotherapy compared to a conventional sedative regimen consisting of continuous infusion fentanyl and midazolam. III. Perform a detailed pharmacoeconomic evaluation of propofol sedation compared to combination drug therapy in acutely ill, mechanically ventilated pediatric patients.
>Trial ID >Title >Status >Phase >Start Date >Summary

Clinical Trial Conditions for Fentanyl-12

Condition Name

Condition Name for Fentanyl-12
Intervention Trials
Pain 161
Postoperative Pain 107
Pain, Postoperative 92
Anesthesia 85
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Condition MeSH

Condition MeSH for Fentanyl-12
Intervention Trials
Pain, Postoperative 247
Acute Pain 56
Vomiting 46
Breakthrough Pain 43
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Clinical Trial Locations for Fentanyl-12

Trials by Country

Trials by Country for Fentanyl-12
Location Trials
United States 865
Egypt 270
Canada 99
China 81
Korea, Republic of 71
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Trials by US State

Trials by US State for Fentanyl-12
Location Trials
California 77
New York 63
Texas 62
North Carolina 50
Illinois 44
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Clinical Trial Progress for Fentanyl-12

Clinical Trial Phase

Clinical Trial Phase for Fentanyl-12
Clinical Trial Phase Trials
Phase 4 564
Phase 3 200
Phase 2/Phase 3 51
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Clinical Trial Status

Clinical Trial Status for Fentanyl-12
Clinical Trial Phase Trials
Completed 890
Recruiting 230
Unknown status 195
[disabled in preview] 247
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Clinical Trial Sponsors for Fentanyl-12

Sponsor Name

Sponsor Name for Fentanyl-12
Sponsor Trials
Cairo University 47
Ain Shams University 40
Mansoura University 38
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Sponsor Type

Sponsor Type for Fentanyl-12
Sponsor Trials
Other 1765
Industry 254
U.S. Fed 33
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Fentanyl Transdermal System: Clinical Trials, Market Analysis, and Projections

Introduction

Fentanyl, a potent synthetic opioid, is widely used in the form of transdermal patches for managing severe, chronic pain in opioid-tolerant patients. This article delves into the clinical trials, market analysis, and projections for the fentanyl transdermal system, particularly focusing on the 12 mcg/hr dosage.

Clinical Use and Pharmacokinetics

Effective Concentration and Steady State

The fentanyl transdermal patch achieves effective serum concentrations within 6-12 hours of application, reaching a steady state in 12-24 hours and maintaining stable levels for up to 72 hours[1][4].

Population-Specific Considerations

The pharmacokinetics of fentanyl vary among different populations. For instance, elderly patients exhibit a slower increase in blood drug concentration compared to younger patients. Children also show variability in peak times, ranging from 18-66 hours[1].

Clinical Trials and Safety

Indications and Contraindications

Fentanyl transdermal systems are indicated for opioid-tolerant patients requiring daily, around-the-clock, long-term opioid treatment. They are contraindicated for opioid non-tolerant patients, acute or intermittent pain, and patients with respiratory compromise or known hypersensitivity to fentanyl[4].

Adverse Reactions and Precautions

Clinical trials highlight the risks associated with fentanyl, including respiratory depression, sedation, and interactions with CNS depressants. Special precautions are necessary for elderly, cachectic, debilitated patients, and those with chronic pulmonary disease or head injuries[4].

Dosage and Titration

The initial dose selection is based on the patient's opioid tolerance, and the dose is titrated based on the daily dose of supplemental opioid analgesics required. It may take up to 6 days for fentanyl levels to reach equilibrium on a new dose[4].

Market Analysis

Illicit Market Impact

Fentanyl, particularly its analogs, has significantly impacted the illicit drug market. The ease of production and distribution via darknet markets has led to a surge in fentanyl-related overdose deaths and altered the traditional heroin supply chain[2][5].

Legitimate Market Demand

In the legitimate market, the demand for fentanyl transdermal systems is driven by the need for effective pain management in opioid-tolerant patients. The market is characterized by strict regulations and guidelines to ensure safe use and minimize the risk of abuse and overdose[1][4].

Market Projections

Growing Need for Pain Management

The increasing prevalence of chronic pain conditions and the limitations of alternative pain management options are expected to drive the demand for fentanyl transdermal systems. However, this growth is tempered by the stringent regulatory environment and the need for careful patient selection and monitoring[1][4].

Technological Advancements

Advancements in detection technologies, such as field-portable drug detection equipment, are expected to enhance the safety and efficacy of fentanyl use by improving the detection of illicit fentanyl analogs and ensuring the purity of legitimate pharmaceuticals[5].

Research and Development

Addressing Overdose and Addiction

Current research focuses on understanding the complexities of fentanyl-induced respiratory depression and developing novel treatment strategies. Studies aim to elucidate the underlying mechanisms and design new therapeutic approaches to combat the opioid crisis exacerbated by fentanyls[3].

Post-Mortem Studies and Mechanisms

Post-mortem studies are crucial in understanding the rapid mortality associated with fentanyl overdoses. Further data collection and improved sampling techniques may provide insights into the mechanisms underlying fentanyl-linked mortalities, guiding the development of more effective treatments[3].

Regulatory Environment

Guidelines and Compliance

The use of fentanyl transdermal systems is heavily regulated, with guidelines emphasizing the need for pharmaceutical care, proper administration, and disposal. Compliance with these regulations is essential to mitigate the risks associated with fentanyl use[1][4].

Key Takeaways

  • Pharmacokinetics: Fentanyl transdermal patches achieve steady state concentrations within 12-24 hours and maintain stable levels for up to 72 hours.
  • Clinical Use: Indicated for opioid-tolerant patients with severe, chronic pain; contraindicated for opioid non-tolerant patients and those with respiratory compromise.
  • Market Impact: Illicit fentanyl analogs significantly affect the drug market, while legitimate demand is driven by the need for effective pain management.
  • Projections: Growing demand for pain management solutions, tempered by regulatory scrutiny and the need for advanced detection technologies.
  • Research: Ongoing studies focus on addressing overdose and addiction, and understanding the mechanisms of fentanyl-induced mortality.

FAQs

Q: What is the typical dosage range for fentanyl transdermal systems?

A: The dosage range for fentanyl transdermal systems includes 12 mcg/hr, 25 mcg/hr, 50 mcg/hr, 75 mcg/hr, and 100 mcg/hr[4].

Q: How long does it take for fentanyl levels to reach equilibrium after a new dose?

A: It may take up to 6 days for fentanyl levels to reach equilibrium on a new dose[4].

Q: What are the primary risks associated with fentanyl transdermal systems?

A: The primary risks include respiratory depression, sedation, and interactions with CNS depressants[4].

Q: Why is fentanyl often preferred over heroin in some illicit markets?

A: Fentanyl is preferred due to its greater potency and the intense "rush" it provides, despite the higher risk of overdose[2].

Q: What are the current research focuses regarding fentanyl?

A: Current research focuses on understanding fentanyl-induced respiratory depression, developing new treatment strategies, and elucidating the mechanisms underlying fentanyl-linked mortalities[3].

Sources

  1. Guidelines for Rational Clinical Use of Fentanyl Transdermal Patch - Dovepress
  2. Fentanyl availability on darknet markets - Australian Institute of Criminology
  3. Expired RFA-DA-22-022: Fentanyl and its Analogs - NIH
  4. Fentanyl Transdermal System - Mallinckrodt Pharmaceuticals
  5. Fentanyl Analogs - PNNL

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