Actiq by Cephalon, is a solid formulation of fentanyl citrate on a plastic stick that dissolves slowly in the mouth for absorption across the buccal mucosa. Cephalon Inc ( is a US biopharmaceutical company co-founded in 1987 by Dr Fentanyl is one of the most powerful Opioid Analgesics with a potency approximately 81 times that of Morphine. The mouth, buccal cavity, or oral cavity is the first portion of the Alimentary canal that receives food and begins digestion by mechanically breaking up Buccal mucosa is Mucous membrane of the inside of the Cheek. It is non-keratinised and is continuous with the mucosae of the soft palate under surface of tongue and Generically Actiq is a form of oral transmucosal fentanyl citrate (OTFC). In the UK, Fentanyl is a Schedule 2 drug of the Misuse of Drugs Act. In the Netherlands, Fentanyl is a List I substance of the Opium Law. In the US, Fentanyl is a Schedule II controlled substance per the Controlled Substance Act. Fentanyl is one of the most powerful Opioid Analgesics with a potency approximately 81 times that of Morphine. The Controlled Substances Act ( CSA) was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control Other pharmaceutical preparations consisting of fentanyl are Durogesic and Duragesic (72 hour continuous-release fentanyl patches) and Fentora, a rapidly dissolving fentanyl lozenge which, like Actiq, is administered transmucosally over the buccal mucosa. Fentanyl is one of the most powerful Opioid Analgesics with a potency approximately 81 times that of Morphine. Duragesic and Durogesic (ˌdɚə'dʒiʒɪk are the trade names of Fentanyl transdermal therapeutic systems, and are used for moderate to severe pain relief Duragesic and Durogesic (ˌdɚə'dʒiʒɪk are the trade names of Fentanyl transdermal therapeutic systems, and are used for moderate to severe pain relief Fentanyl is one of the most powerful Opioid Analgesics with a potency approximately 81 times that of Morphine. Fentanyl is one of the most powerful Opioid Analgesics with a potency approximately 81 times that of Morphine. Buccal mucosa is Mucous membrane of the inside of the Cheek. It is non-keratinised and is continuous with the mucosae of the soft palate under surface of tongue and OTFC is absorbed much like how nicotine is absorbed when dip is placed in one's mouth between the gum and cheek. Nicotine is an Alkaloid found in the Nightshade family of plants ( Solanaceae) which constitutes approximately 0

Contents 1 Administration 2 Absorption 3 Dosing 4 Side-effects 5 Generic Alternatives 6 References 7 External links

Administration

Around 100 times stronger than morphine^[1], Actiq is intended for opiate-tolerant individuals and is effective in treating cancer breakthrough pain. Medical uses Morphine can be used as an analgesic in hospital settings to relieve pain in Myocardial infarction pain in For other uses see Opiate (disambiguation, or for the class of drugs see Opioid. Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled Breakthrough pain is Pain that comes on suddenly for short periods of time and is not alleviated by the patients' normal pain suppression management However, it is often prescribed for "off-label uses", i. Off-label use is the practice of prescribing drugs for a purpose outside the scope of the drug's approved label most often concerning the drug's indication. e. not for cancer patients, such as bone injuries, migraines, severe back pain, cluster headaches, neuropathy, arthritis, and other situations of moderate to severe chronic, non-malignant pain. Bones are rigid organs that form part of the Endoskeleton of Vertebrates They function to move support and protect the various organs of the body produce Migraine is a neurological Syndrome characterized by altered bodily experiences painful headaches and nausea Back pain (also known " dorsalgia " is Pain felt in the back that usually originates from the Muscles Nerves Bones A headache ( cephalalgia in medical terminology is a condition of pain in the Head; sometimes Neck or upper back pain may also be interpreted Neuropathy is a medical term usually short for Peripheral neuropathy. Arthritis (from Greek arthro-, joint + -itis, inflammation plural arthritides is a group of conditions involving damage to the Joints of the body Malignant (from the Latin roots mal- = "bad" and -genus = "born" is a medical term used to describe a severe and progressively worsening disease ^{[1] [2] [3]}

The Actiq dosage unit is a white, berry-flavored lozenge on a stick which is swabbed on the buccal mucosa, between cheek and gum to release the fentanyl quickly into the bloodstream. Applications Modal logic In Modal logic, the lozenge expresses the possibility of the following expression Fentanyl is one of the most powerful Opioid Analgesics with a potency approximately 81 times that of Morphine. It is most effective when the lozenge is consumed in exactly 15 minutes, as the balance of the drug absorbed through the cheeks and the amount swallowed is maintained.

Absorption

Normally 25% of the drug is absorbed via the buccal mucosa directly into the bloodstream while the remaining 75% is swallowed and then slowly absorbed in the gastrointestinal tract. Two-thirds of the swallowed Actiq (or 50% of the total dose) is metabolized by the liver and becomes unavailable for any pain relief function, leaving only around 33% of the ingested fentanyl available for pain relief. This is why the drug is far less potent if consumed orally compared to transmucosally.

Dosing

Actiq is available in 6 dosages, measured in micrograms: 200, 400, 600, 800, 1200, & 1600 mcg. In the Metric system, a microgram is 1/1000000 of a Gram (1 × 10-6 or 1/1000 of a milligram is one of the smallest units of weight/mass commonly used Each dosage strength has its own color box and plastic handle:

Actiq 200 mcg--gray Actiq 400 mcg--blue Actiq 600 mcg--orange Actiq 800 mcg--purple Actiq 1200 mcg--green Actiq 1600 mcg--burgundy

Side-effects

Actiq, like all opioids, has a potential for abuse and can be habit forming. Actiq should not be taken with alcohol. Although Actiq was only approved by the FDA for treatment of intractable pain in cancer patients, it has been estimated that in the first half of 2006 approximately 90-99% of the 187,076 Actiq prescriptions filled in the U. Cancer (medical term Malignant Neoplasm) is a class of Diseases in which a group of cells display uncontrolled S. were for "off-label uses", i. Off-label use is the practice of prescribing drugs for a purpose outside the scope of the drug's approved label most often concerning the drug's indication. e. not for cancer patients. ^[1], ^[2] Actiq was reported to be one of many legally prescribed addictive medications found in Anna Nicole Smith's room when she died. Vickie Lynn Marshall (November 28 1967 &ndash February 8 2007 better known under the Stage name of Anna Nicole Smith, was an American model ^[1]

As with all opioids, there have also been reports of illicit use on the street, where it is (incorrectly) known as "morphine lollypops", and in the US as "perc-a-pop", and sells for between €5-25, depending on its dose. ^[4] The attorneys-general of Connecticut and Pennsylvania have launched investigations into its diversion from the legitimate pharmaceutical market, including Cephalon's "sales and promotional practices for Provigil, Actiq and Gabitril". Connecticut ( is a state located in the New England region of the northeastern United States of America. The Commonwealth of Pennsylvania ( often colloquially referred to as PA (its abbreviation by natives and Northeasterners is a state located in the Northeastern Modafinil ( Provigil) is a stimulant-like drug manufactured by Cephalon, and is approved by the FDA for the treatment of Narcolepsy Tiagabine (taɪˈæɡəbiːn] is an anti-convulsive ^[4] In order to curb misuse, many health insurers have begun to require precertification and/or quantity limits for Actiq prescriptions. The term " managed care " is used to describe a variety of techniques intended to reduce the cost of providing health benefits and improve the quality of care ("managed care ^[5],^[6],^[7]

An Actiq lozenge contains 2 grams of sugar ^[8] (8 calories), making weight gain and tooth decay a conceivable concern for patients who consume many Actiqs per day. ^[3] Diabetics also need to take Actiq's sugar content into account. Diabetes mellitus (ˌdaɪəˈbiːtiːz or /ˌdaɪəˈbiːtəs/ /məˈlaɪtəs/ or /ˈmɛlətəs/ often referred to simply as diabetes ( Ancient Greek: grc A sugar-free version, called Actiq-SF, is in development, and should be available beginning first quarter 2007. Sugar is a class of edible Crystalline substances mainly Sucrose, Lactose, and Fructose. Side effects include the normal side effects found with this class of narcotic analgesic plus constipation and dry mouth. In Medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as Chemotherapy or Surgery. The term narcotic (ναρκωτικός is believed to have been coined by the Greek physician Galen to refer to agents that benumb or deaden causing loss Constipation, costiveness, or irregularity, is a condition of the Digestive system in which a person (or animal experiences hard Feces that Xerostomia is the medical term for a dry mouth due to a lack of Saliva. Other side effects include rash, sweating, hot flashes, and dizziness.

Generic Alternatives

Beginning late September, 2006, a generic version of Actiq has been available, made by Barr Pharmaceuticals. Barr Pharmaceuticals Inc, ( is global specialty pharmaceutical company that operates in more than 30 countries worldwide and is engaged in the development manufacture and marketing Cephalon has begun marketing its own version of generic Actiq to compete in the generic OTFC market. Cephalon Inc ( is a US biopharmaceutical company co-founded in 1987 by Dr The generic versions of Actiq, simply called "oral transmucosal fentanyl citrate," are packaged just like name brand Actiq, and there is no difference in appearance, active and inactive ingredients, or function as compared to the name brand Actiq. Because Actiq is extremely expensive, the generic OTFC just hitting the market will likely make the drug more accessible.

References

External links

• Official Actiq website.
• Consent Order Requires Cephalon to Grant Third-Party License to Sell Generic Actiq in U.S.
• Barr Pharmaceuticals (2006-09-27). Barr Launches Generic ACTIQ(R) Cancer Pain Management Product. Press release.

Prime Therapeutics LLC is a Pharmacy Benefit Manager (PBM headquartered in Eagan Minnesota and is owned by Several Blue Cross Blue Shield Health Plans which has two contact centers The Salt Lake Tribune is the largest-circulated daily newspaper in the U Aetna Inc ( is an American diversified Health care benefits company providing a range of traditional and Consumer directed health care insurance

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