Oral transmucosal opioids

The oral transmucosal routes are buccal and sublingual. The absorption of drugs across the oral mucosa involves a process of passive absorption, and may involve either the transcellular route or the paracellular route. A number of drug factors affect the absorption of drugs across the oral mucosa. Oral transmucosal drug delivery does not require expertise, preparation, or technical equipment. Oral transmucosal administration may be associated with rapid onset of analgesia. A number of fentanyl-based formulations are commercially available to manage breakthrough cancer pain. A variety of other opioids have been subject to oral transmucosal administration. However, many of these opioids are not very lipophilic and, therefore, not suited for buccal or sublingual administration. Some of the more successful ones are alfentanil and sufentanil.