Use of a Long-Acting Opioid Microsphere Formulation to Overcome Difficulties in Swallowing Pain Medication

2020 (Active)

Nathan Anderson,1 Andrea G Gillman,1 and Ajay D Wasan1,2

To achieve optimal care for pain patients, pain medication should provide satisfactory analgesia and minimize patient burdens such as the effort required to swallow pills. Although there are risks of abuse, overdose, and side effects,1 long-term low- or moderate-dose opioid medication can provide effective and safe analgesia in well-selected patients with chronic pain. However, long-acting opioid pill capsules are often large and difficult for patients to swallow.2 Studies have shown that 20% of adult patients have difficulty swallowing their medications, and up to 10% refuse specific pharmaceutical therapies because they cannot swallow the pills.3,4 Pill swallowing difficulty can be due to several factors, including capsule size, outer coating texture, shape, and taste,5,6 and it is likely that swallowing difficulties compromise the quantity, quality, and satisfaction with pain relief from oral opioids. This issue disproportionately affects patients with cancer pain, as chemotherapy, radiation, and/or surgical treatments may result in increased swallowing difficulties.

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