Uso de fentanil em sistemas de liberação transdérmica: uma revisão descritiva sobre seus aspectos biofarmacêuticos, de segurança e eficácia

Abstract

Resumo em outro idioma: Introduction: Pain control, whether acute or chronic, requires specific approaches due to its different characteristics and intensities. Pain can limit daily activities and generate dependence on external care, especially when treatment requires frequent intravenous medication, or when it interrupts the patient's routine and increases the risk of hospitalization and drug resistance. The use of transdermal delivery system, such as the fentanyl patch, emerges as an alternative to overcome these challenges, allowing continuous dosing, less need for clinic visits and greater independence. This method contributes to a more comfortable and safe pain management. Objective: This study aimed to conduct a descriptive review on the use of fentanyl in transdermal patches, addressing pharmacological aspects, therapeutic advantages and challenges in pain management. Based on scientific publications from academic databases, we sought to analyze the efficacy and safety of this controlled release system. Method: The search was conducted in the PubMed, Web of Science and Google Scholar databases, covering the period from 1992 to 2024. The descriptors “Fentanyl” and “'transdermal patch'” were used. The selected articles were fully analysed to collect relevant data. Results: Thirty-one articles on the use of the transdermal fentanyl patch were analyzed, with frequent comparisons with the standard morphine treatment. The transdermal fentanyl patch (TFP) presents itself as an effective and safe alternative in the management of chronic and acute pain, standing out mainly in the treatment of oncology patients and in the postoperative period. The analyzed studies confirm the efficacy of the TFP, reducing pain intensity and dependence on additional analgesics, while presenting a favorable adverse effect profile compared to other therapies, such as oral morphine. The results indicated that fentanyl offers better analgesic performance and comfort in pain management, especially in patients with chronic pain, such as non-cancer patients, and in postoperative situations. Its application offers advantages over other forms of opioid administration, providing more effective pain control and better quality of life, with less need for periodic interventions. The fentanyl patch proved to be effective in controlling chronic and acute pain, with advantages over other pharmaceutical forms, such as greater convenience and less need for interventions. When used correctly, it provides effective pain control, with fewer complications associated with other routes of administration. However, the occurrence of side effects, such as nausea, mortality, and constipation, highlights the importance of adequate monitoring, especially at higher doses. Conclusion: Thus, the present study showed that the transdermal fentanyl patch represents a promising therapeutic option, as long as it is administered with individual care and adjustments, reinforcing its relevance in multimodal analgesia protocols