Supportive Care in Cancer

, Volume 27, Issue 10, pp 3639–3645 | Cite as

Intranasal therapy with opioids for children and adolescents with cancer: results from clinical studies

  • Silvia TriaricoEmail author
  • Michele Antonio Capozza
  • Stefano Mastrangelo
  • Giorgio Attinà
  • Palma Maurizi
  • Antonio Ruggiero
Review Article


Opioids are essential for the treatment of pain, which is a serious symptom for children and adolescents affected by cancer. Intranasal opioids may be very useful for the treatment of breakthrough pain in children and adolescents with cancer, for their little invasiveness, ease of administration, rapid onset of action, and high bioavailability. Intranasal drug delivery may be influenced by anatomical and physiological factors (nasal mucosa absorption area, mucociliary clearance, enzymatic activity, anatomical anomalies, chronic or inflammatory alterations of nasal mucosa), drug-related factors (molecular weight, solubility), and delivery device. Fentanyl is a lipophilic opioid commonly proposed for intranasal use among pediatric patients, but no studies have been conducted yet about intranasal use of other available opioids for management of pediatric cancer pain. In this review, we analyze several elements which may influence absorption of intranasal opioids in children and adolescents, with a focus on pharmacokinetics and therapeutic aspects of each opioid currently available for intranasal use.


Intranasal Opioids Cancer pain Pediatric patients Fentanyl 


Funding information

This work was supported by Fondazione per l’Oncologia Pediatrica.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Silvia Triarico
    • 1
    Email author
  • Michele Antonio Capozza
    • 1
  • Stefano Mastrangelo
    • 1
  • Giorgio Attinà
    • 1
  • Palma Maurizi
    • 1
  • Antonio Ruggiero
    • 1
  1. 1.Pediatric Oncology Unit, Foundation “A. Gemelli”Catholic University of Sacred HearthRomeItaly

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