Clinical trial · Interventional
Fentanyl for Breakthrough Pain in the Emergency Department
A Randomized Controlled Double-Blind Trial of Fentanyl Nasal Spray (Lazanda) Plus Hydromorphone Demand PCA Versus Placebo Nasal Spray Plus Hydromorphone Demand PCA for Treatment of Breakthrough Cancer Pain in the Emergency Department
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
The goal of this clinical research study is to learn if fentanyl nasal spray can help decrease pain related to cancer when used with other drugs for pain. Researchers also want to know if this drug can help decrease the length of your stay in the Emergency Department. In this study, fentanyl nasal spray will be compared to a placebo nasal spray. A placebo is not a drug. It looks like the study drug but it is not designed to treat any disease or illness. It is designed in this study to be compared with the study spray to learn if the study spray has any real effect. You will also be given intravenous (IV) pain drugs. You will be given these drugs even if you decide not to take part in this study.
Conditions
Conditions (1)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Pain | — | UNRESOLVED | — |
Interventions
Interventions (3)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Fentanyl Nasal Spray | Drug | — | UNRESOLVED |
| Hydromorphone PCA | Drug | — | UNRESOLVED |
| Placebo Nasal Spray | Other | — | UNRESOLVED |
Design
Arms and outcomes
Arms (2)
- type
- EXPERIMENTAL
- label
- Fentanyl Nasal Spray + Hydromorphone PCA
- description
- Fentanyl 100 mcg nasal spray administered plus hydromorphone PCA. All study patients receive demand dosing patient-controlled analgesia (PCA) with intravenous hydromorphone. Initial loading dose 0.2 mg with demand doses of 0.2 mg and lockout interval of 15 minutes. There will be no basal dose and the 8-hour dose limit will be 6.4 mg.
- interventionNames
- Drug: Fentanyl Nasal Spray
- Drug: Hydromorphone PCA
- type
- EXPERIMENTAL
- label
- Placebo Nasal Spray + Hydromorphone PCA
- description
- Placebo nasal spray administered plus hydromorphone PCA . All study patients receive demand dosing patient-controlled analgesia (PCA) with intravenous hydromorphone. Initial loading dose 0.2 mg with demand doses of 0.2 mg and lockout interval of 15 minutes. There will be no basal dose and the 8-hour dose limit will be 6.4 mg.
- interventionNames
- Drug: Hydromorphone PCA
- Other: Placebo Nasal Spray
Eligibility
Eligibility (as posted)
- Sex
- All
- Minimum age
- 18 Years
- Maximum age
- 75 Years
Show eligibility criteria text
Inclusion Criteria: 1. Cancer patients presenting to the Emergency Department for treatment of acute breakthrough pain who are already receiving and who are tolerant to opioid therapy for their underlying persistent cancer pain. (Patients considered opioid tolerant are those who are taking at least: 60 mg of oral morphine/day, 25 mcg of transdermal fentanyl/hour, 30 mg oral oxycodone/day, 8 mg oral hydromorphone/day, 25 mg oral oxymorphone/day, or an equianalgesic dose of another opioid for a week or longer.) 2. Patients must have severe pain on an 11-point Numeric Rating Scale (NRS 7-10) 3. Breakthrough cancer pain must be of sufficient severity to warrant the use of intravenous opioids in the judgment of the treating emergency physician 4. Age between 18 and 75 years 5. Able to understand the description of the study and give informed consent 6. Patients must be willing to and capable of providing frequent pain assessments for up to 8 hours 7. English-speaking Exclusion Criteria: 1. Patients will not be approached while they are in acute distress and those exhibiting symptoms (such as dyspnea, uncontrolled nausea/vomiting or vertigo) to such an extent that impairs their ability to understand and evaluate informed consent 2. Patients participating in other clinical trials for pain 3. Patients who are not already tolerant to opioids 4. Patients, who in the judgment of the treating clinician, are suspected to have hepatic or renal failure 5. Patients who are pregnant or lactating 6. Patients with a known allergy or significant reaction to fentanyl, the components of the IN formulation, hydromorphone, or other opioids 7. Patients already on high morphine equivalent daily dose (MEDDs) (\>500 mg/day).
References
Publications (0)
Data not yet available