To the Editor

1 Dietrich E , Gums JG . Intranasal fentanyl spray: a novel dosage form for the treatment of breakthrough cancer pain. Ann Pharmacother 2012; 46: 1382–91. DOI: 10.1345/aph.1R069

2 Fisher A , Watling M , Smith A , Knight A . Pharmacokinetics and relative bioavailability of fentanyl pectin nasal spray 100–800 μg in healthy volunteers. Int J Clin Pharmacol Ther 2010; 48: 860–7.

3 Kaasa S , Moksnes K , Nolte T , et al. Pharmacokinetics of intranasal fentanyl spray in patients with cancer and breakthrough pain. J Opioid Manag 2010; 6: 17–26.

4 Portenoy RK , Burton AW , Gabrail N , Taylor D ; Fentanyl Pectin Nasal Spray 043 Study Group. A multicenter, placebo-controlled, double-blind, multiple-crossover study of fentanyl pectin nasal spray (FPNS) in the treatment of breakthrough cancer pain. Pain 2010; 151: 617–24.

5 European Medicines Agency. Assessment Report for Instanyl. Procedure No. EMEA/H/C/959. Doc. Ref: EMEA/290364/2009. Pivotal study FT-017-IM. http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Public_assessment_report/human/000959/WC500033144.pdf (accessed 2012 Dec 1).