Quick-dissolve sublingual tablets help make fast relief simple

Quick and easy administration means fast relief of breakthrough cancer pain (BTcP)1,2


Suitable for patients who have difficulty with oral medication4

Unique micronized technology absorbs fast to deliver rapid relief1,2

  • One tablet under the tongue dissolves fast for rapid-onset relief1
  • Easy to take and easy for caregivers to administer1,3
  • Conveniently packaged in single-dose, easy-to-carry blister packs1
  • Hassle-free disposal, with no special disposal or biohazard requirements1
  • Available in 6 sugar-free strengths for flexible titration1
  • Subsequent BTcP episodes can be treated 2 hours after last dose of ABSTRAL1

Quick-dissolve tablet
dissolves in seconds3


Noninvasive delivery is tolerable for patients who have

  • Nausea, vomiting, dysphagia, or odynophagia4
  • Difficulty administering medication4

ABSTRAL quick-dissolve sublingual tablets dissolve faster than buccal tablet formulations3

In a patient-preference study, patients preferred sublingual tablets over buccal tablets and nasal spray3

  • Easy to access and administer
  • Dissolves rapidly
  • No bad taste


Sublingual tablets dissolved in less than 1 minute3

Survey of 30 patients with cancer to evaluate different routes of transmucosal fentanyl formulations. Patients received and administered a placebo of each product and were asked to rate them using a 7-point Likert agree-disagree scale and free-text responses, with regard to ease of access and administration, palatability, and overall impression.3

Transmucosal tablets time to dissolve


Patients preferred ABSTRAL for speed and ease of use5



of patients said ABSTRAL was easier to handle5

84% of patients chose to continue taking ABSTRAL for relief of breakthrough pain5

Prospective, multicenter, open-label, Phase 4 study of 181 opioid-tolerant adult cancer patients with breakthrough pain. Patients received ABSTRAL sublingual tablets with a median dose of 401.4 mcg in the course of routine clinical practice. Patients completed questionnaires over a 28-day observation period. Efficacy was assessed using measures of maximum breakthrough pain intensity and time to first effect and maximum effect of ABSTRAL.5

Percent of patients who preferred ABSTRAL sublingual tablets


For opioid-tolerant patients1

Patients receiving ABSTRAL should be taking around-the-clock pain medication consisting of one of the following1

  • Oral morphine ≥60 mg daily
  • Transdermal fentanyl ≥25 mcg per hour
  • Oral oxycodone ≥30 mg daily
  • Oral hydromorphone ≥8 mg daily
  • Oral oxymorphone ≥25 mg daily
  • Equianalgesic dose of another opioid medication daily for a week or longer

Flexible titration to adjust to every patient’s needs1

ABSTRAL quick-dissolve sublingual tablets are available in 6 sugar-free strengths for flexible titration1

ABSTRAL dose titration

  • ABSTRAL should not be converted on a mcg-per-mcg basis from other transmucosal fentanyl products1
  • The effective and tolerable dose of ABSTRAL is determined by dose titration in individual patients1
  • Begin all patients on an initial dose of 100 mcg1
  • If adequate pain relief is not achieved after 30 minutes, administer a second 100 mcg dose1
  • Dosing for subsequent episodes should be separated by at least 2 hours1
  • During titration, patients can be instructed to use multiples of 100 mcg tablets and/or 200 mcg tablets for any single dose1
  • If patient continues to experience >4 breakthrough pain episodes per day, reevaluate dose of persistent pain medication1

Please consult the full Prescribing Information for complete dosing instructions.

*Efficacy and safety of doses higher than 800 mcg have not been evaluated in clinical studies.1

When prescribing, do not convert patients on a mcg-per-mcg basis from another fentanyl product to ABSTRAL. Patients beginning treatment with ABSTRAL must begin with titration from the 100 mcg dose.

When dispensing, do not substitute an ABSTRAL prescription for other fentanyl products. Differences exist in the pharmacokinetics of ABSTRAL compared to other fentanyl products that could result in clinically important differences in the amount of fentanyl absorbed and could result in fatal overdose.

Special care must be used when dosing ABSTRAL. If the breakthrough pain episode is not relieved patients must wait at least 2 hours before treating another episode of breakthrough pain with ABSTRAL.


  1. ABSTRAL [package insert]. Lake Oswego, OR: Galena Biopharma Inc; 2013.
  2. Chrvala CA, Caspi A. Abstral (fentanyl sublingual tablets for breakthrough cancer pain). P&T Product Profiler. 2011;36(2):2-28. 
  3. England R, Maddocks M, Manderson C, Zadora-Chrzastowska S, Wilcock A. How practical are transmucosal fentanyl products for breakthrough cancer pain? novel use of placebo formulations to survey user opinion. BMJ Support Palliat Care. 2011;1:349-351.
  4. Raber-Durlacher JE, Brennan MT, Verdonck-de Leeuw IM, et al. Swallowing dysfunction in cancer patients. Support Care Cancer. 2012;20(3):433-443.
  5. Überall MA, Müller-Schwefe GH. Sublingual fentanyl orally disintegrating tablet in daily practice: efficacy, safety and tolerability in patients with breakthrough cancer pain. Curr Med Res Opin. 2011;27(7):1385-1394.