fentanyl citrate / Generic mfg. - LARVOL DELTA

Abdominal Compression Device Reduces Procedural Sedation in Higher-Risk Patients Undergoing Colonoscopy: A Within-Subject Analysis (ACG 2026) - "Controls showed no fentanyl change (+4%, p=0.57) and increased versed (+44%, p< 0.001). ACD use reduced both agents: fentanyl â28% (p< 0.001) and versed â13% (p=0.03), each significantly below the control trajectory (p< 0.001). Particular benefit was observed in non-obese patients qualifying by prior high sedation, who showed the largest reductions (fentanyl â37%, versed â24%; both p< 0.001)."

Clinical • Genetic Disorders • Obesity

Remimazolam-Fentanyl Versus Midazolam-Fentanyl for Moderate Sedation in Outpatient Gastrointestinal Endoscopy: A Retrospective Cohort Study (ACG 2026) - "Of 3,986 procedures (650 EGD, 3,336 colonoscopy), sedation duration was 23% shorter with RF for EGD (10 vs 13 min, p< 0.001) and 14% shorter for colonoscopy (24 vs 28 min, p< 0.001). Phase II recovery was 5â6 minutes shorter (p< 0.001) (Figure 2), despite lower fentanyl doses. Hypercapnia was significantly lower with RF (8.5% vs 18.9%, OR 0.40, p< 0.001); bradycardia (OR 0.56) and hypoxemia (OR 0.66) were also lower."

Retrospective data • Cardiovascular

Avoiding the Anchor: A Painful Assumption After Endoscopic Resection (ACG 2026) - "He received fentanyl and dexmedetomidine with minimal relief as well as ciprofloxacin and metronidazole. Figure: a) Occlusion of the right external iliac artery. b) Severe stenosis of the superior mesenteric artery."

Atherosclerosis • Cardiovascular • Dyslipidemia • Genetic Disorders • Hypertension • Neurofibromatosis • Solid Tumor

Diagnosis and Treatment Gaps in Opioid-Induced Constipation: A National Real-World Analysis Using the Epic Cosmos EHR Network (ACG 2026) - "Adults â¥18 years with chronic opioid exposure (â¥3 prescription orders spanning â¥90 days; hydrocodone, oxycodone, morphine, fentanyl, tramadol, or methadone) were included...During 12 months of follow-up, we assessed formal OIC diagnosis (K59.03), laxative prescriptions, PAMORA prescriptions (methylnaltrexone, naloxegol, naldemedine), and constipation-related ED visits or hospitalizations (K59.0x, K56.41)... Among chronic opioid users, 40.73% received laxatives, while only 8.81% had a formal OIC diagnosis, representing a >4-fold gap between treatment and documented coding. PAMORA prescribing was 13.97%, exceeding formal diagnosis rates and suggesting targeted therapy may occur despite absent structured OIC coding. Constipation-related complications increased with age (18â44: 0.48%; â¥85: 1.37%), whereas PAMORA prescribing was lowest in patients â¥85 years (11.57%) despite higher complication burden."

Clinical • Real-world • Real-world evidence • Constipation • Gastroenterology • Gastrointestinal Disorder

Underrepresentation of Patient-Reported Outcomes in Gallbladder Cancer Trials: A Systematic Review Utilizing ClinicalTrials.gov (ACG 2026) - "One Phase II study evaluating gemcitabine, capecitabine, and bevacizumab utilized the Functional Assessment of Cancer Therapy-Hepatobiliary (FACT-Hep) questionnaire to assess HRQoLs at predefined treatment intervals. Another Phase III study evaluating fentanyl sublingual spray for breakthrough cancer pain incorporated patient-reported pain intensity, pain relief, treatment satisfaction, and global medication evaluation as secondary outcomes using Visual Analog scale for pain intensity and Total Pain Relief (TOTPAR)... 36 completed interventional trials met the inclusion criteria, majority of which were phase II studies and a small number of phase III studies. Most commonly reported endpoints included progression-free survival, overall survival, objective response rate, and treatment related toxicity. PROs were not frequently incorporated into trial design inspite of growing emphasis on patient centered oncology care."

Clinical • Patient reported outcomes • Review • Gallbladder Cancer • Oncology • Solid Tumor

Cytotoxic Lesion of the Corpus Callosum After Hospital-Administered Intravenous Fentanyl for Trigeminal Neuralgia: A Case Report and Focused Review. (PubMed, Clin Neuropharmacol) - "This case expands the neuroimaging spectrum of fentanyl-associated brain injury and supports a toxic-metabolic pathogenesis in which splenial CLOCC may represent a focal manifestation of broader opioid-related white-matter vulnerability."

Journal • Review • CNS Disorders • Neuralgia • Pain • Pediatrics • Vascular Neurology

A Wireless Wearable Platform for Intravenous Drug Self-Administration in Freely Behaving Rats. (PubMed, bioRxiv) - "By measuring spontaneous locomotion, amphetamine-induced hyperlocomotion and food-reinforced operant responding, we show that WEARIT leaves these behaviors unchanged. Remotely triggered fentanyl infusions yielded reliable delivery with physiological responses confirmed by pulse oximetry, and self-administration acquisition and dose-response functions were comparable to conventional tethered systems. WEARIT removes a longstanding constraint on intravenous pharmacology, opening self-administration paradigms to naturalistic and enriched environments and to concurrent imaging or optogenetic manipulation of the circuits engaged by drug reinforcement."

Journal • Preclinical

The evolving epidemiology of opioid use disorder: polysubstance use, drug supply transformation, and policy implications. (PubMed, Front Public Health) - "Literature published between 2010 and 2026 was identified through PubMed, Scopus, and Google Scholar using terms related to OUD, fentanyl, polysubstance use, and treatment strategies...Opioid use disorder needs to be recognized within a wider context of polysubstance risk rather than seen as a solely opioid issue. Successful strategies demand comprehensive policy responses, enhanced harm reduction measures, and flexible surveillance systems that can adapt to rapid shifts in drug availability and usage trends."

Journal • Review • Addiction (Opioid and Alcohol) • Substance Abuse

Comparative Study of Efficacy of Preemptive Use of Opioid-free Anesthesia Using Paracetamol, Magnesium Sulfate, Lignocaine, Dexamethasone versus Intravenous Fentanyl for Attenuating Hemodynamic Response, Perioperative Analgesia, and Postoperative Recovery Profile during Laparoscopic Cholecystectomy: A Randomized Parallel Group Trial. (PubMed, Ann Afr Med) - "OFA provides effective intraoperative analgesia with improved postoperative outcomes. OFA represents a safe and viable alternative to fentanyl-based anesthesia in laparoscopic cholecystectomy."

Journal • Anesthesia • CNS Disorders • Depression • Pain • Psychiatry

Real-World Claims Data on Prescribed Drugs and the Associated Drug-Drug Interaction Risk in Sickle Cell Disease in the United States. (PubMed, Clin Transl Sci) - "The high prescription rates of the CYP3A4 substrates oxycodone (40%) and fentanyl (18.5%), associated with potentially serious clinical consequences due to DDIs, highlight the importance of considering CYP3A4 interaction risk during development of novel therapies for SCD. Overall, this analysis provides a population-level insight into prescription patterns and subsequent DDI risks for people living with SCD. We expect these findings to (1) create clinical DDI risk awareness for this population and (2) inform strategic planning of DDI assessments during development of novel therapies indicated for SCD."

Journal • Real-world evidence • Genetic Disorders • Hematological Disorders • Pain • Sickle Cell Disease • CYP3A4

Discordance between self-reported and detected synthetic opioids reveals cychlorphine emergence among people who inject drugs in Estonia. (PubMed, Int J Drug Policy) - "There is a substantial gap between self-reported and actual synthetic opioid use within a rapidly evolving opioid market. Emergence of previously unrecognised substances such as cychlorphine place people who inject drugs at heightened risk of overdose."

Journal • Addiction (Opioid and Alcohol)

"I Didn't Know I Carried That": Confronting Bias From Emotional Imprints in Substance Use Disorder Nursing Education. (PubMed, J Nurs Educ) - "Using a qualitative descriptive design, 115 junior and senior nursing students in a mental health nursing course completed an anonymous reflective survey after hearing a guest lecture by a nurse in recovery from fentanyl diversion...Six themes emerged: stigma reduction, empathy, recognition of addiction as disease, universality, unresolved pain, and emotional awakening. Narrative exposure fostered empathy, reflection, and compassionate, person-centered care."

Journal • CNS Disorders • Pain • Psychiatry

Optimal buprenorphine exposure to treat patients with opioid use disorder in the era of fentanyl and polysubstance use. (PubMed, Front Pharmacol) - "Older age and Black/African American race were associated with a lower dropout risk. Altogether, these analyses provide important insights into optimal buprenorphine exposure targets and advance understanding of patient treatment journey in the era of synthetic opioids and stimulant co-use."

Journal • Addiction (Opioid and Alcohol) • Substance Abuse

A wearable acoustofluidic patch for rapid reversal of opioid overdose. (PubMed, Nat Commun) - "Moreover, our wearable patch has demonstrated successful reversal of fentanyl overdose in a mouse model, showing significantly reduced detection time, duration, and severity of overdose events, compared to the conventional method. This innovative approach may provide a promising means for personalized healthcare and digital therapy against acute disease."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Depression • Pain • Psychiatry

Belzutifan for Renal Cell Carcinoma in von Hippel-Lindau Disease. (PubMed, N Engl J Med) - P2 | "Belzutifan was associated with predominantly grade 1 and 2 adverse events and showed activity in patients with renal cell carcinomas and non-renal cell carcinoma neoplasms associated with VHL disease. (Funded by Merck Sharp and Dohme and others; MK-6482-004 ClinicalTrials.gov number, NCT03401788.)."

Journal • Fatigue • Genito-urinary Cancer • Hematological Disorders • Oncology • Renal Cell Carcinoma • Solid Tumor • Von Hippel-Lindau Syndrome • CA9 • EPAS1 • VHL

Cocaine-Related Overdose Deaths in Cuyahoga County, Ohio, 2014 to 2024: The Impact of Fentanyl on Cocaine Related Overdose Deaths. (PubMed, Am J Forensic Med Pathol) - "Cocaine without fentanyl overdose deaths were more common in older (>45) Black men living in Cleveland. This study demonstrates the utility of an accredited medical examiner's office data in disaggregating polysubstance overdose death data by (a) identifying important subpopulations within the overdose crisis; (b) informing targeted public health education and interventions."

Journal

Opioid Analgesia in Acute Myocardial Infarction: Pharmacokinetic Interaction with P2Y12 Inhibitors and Pharmacodynamic Consequences-A Clinical Review for Emergency Physicians. (PubMed, J Emerg Med) - "In practice, pain relief should proceed alongside diagnosis and reperfusion. Nitroglycerin is appropriate when hemodynamics allow; an opioid is reasonable for severe pain that persists despite tolerated anti-ischemic therapy or when nitrates cannot be used. Small titrated doses, reassessment before redosing, and clear communication of opioid exposure, vomiting, shock, and P2Y12 loading time are more defensible than routine administration."

Journal • PK/PD data • Cardiovascular • Hematological Disorders • Myocardial Infarction • Pain • Thrombosis

Lessons from the Introduction of Oral Transmucosal Fentanyl Citrate as Pre-Hospital Analgesia in the Mountain Rescue Service of England and Wales. (PubMed, Wilderness Environ Med) - "The absence of significant adverse effects, suggests that OTFC can be used safely in selected patients by healthcare professionals and trained non-healthcare personnel. OTFC maybe a suitable drug to use in MCIs."

Journal • Pain

Economic evaluations of remifentanil versus fentanyl for analgo-sedation in mechanically ventilated adult ICU patients: a systematic review. (PubMed, Intern Med J) - "This systematic review identified limited and heterogeneous evidence regarding the economic impact of remifentanil in mechanically ventilated ICU patients. Given the substantial costs of intensive care, high-quality economic evaluations using contemporary clinical practice, comprehensive cost measurement and appropriate time horizons are needed to determine whether remifentanil provides value for money."

HEOR • Journal • Review • Anesthesia • Critical care • Mood Disorders • Pain • Psychiatry

Clinical Characterization of Multi-Agent Injection Drug Use: Cutaneous Manifestations Suggestive of Xylazine and Fentanyl-Like/Desomorphine Exposure (ACS-CLINCON 2026) - "Abstract is embargoed at this time."

Clinical

Detection of trace fentanyl in latent and developed fingermarks using atmospheric solids analysis probe (ASAP) mass spectrometry. (PubMed, Forensic Sci Int) - "This highlights that trace chemicals can be retained in fingermarks and recovered after development, the success of a simple liquid extraction method to recover analytes of interest and demonstrates how ambient ionisation methods are capable of reliably detecting analytes such as synthetic opioids from a complex matrix. This further exemplifies ambient ionisation as a solution to forensic testing backlogs by providing valuable information to criminal investigations quickly and effectively."

Journal • Addiction (Opioid and Alcohol)

Unexpected Prolonged Apnea Following Succinylcholine in a Medically Complex Patient: A Case Report. (PubMed, Cureus) - "Induction included propofol, fentanyl, and succinylcholine 100 mg...Because enzyme activity, dibucaine inhibition, genetic testing, and quantitative neuromuscular monitoring were not obtained, the diagnosis remained presumptive. This case emphasizes that four qualitative twitches do not establish adequate neuromuscular recovery and that persistent ventilatory failure after improved consciousness warrants continued evaluation for neuromuscular blockade."

Journal • Anesthesia • Critical care

Perioperative Pain in the Era of Emerging and Unregulated Substances: Recognition, Risk Assessment, and Management. (PubMed, Curr Pain Headache Rep) - "Patients may be exposed intentionally or unknowingly to fentanyl and nitazenes, xylazine and medetomidine, kratom and concentrated 7-hydroxymitragynine products, tianeptine, phenibut, and other psychoactive substances. Perioperative planning should integrate physiologic findings with the limitations of toxicology testing and distinguish surgical pain from tolerance, withdrawal, opioid-induced hyperalgesia, and delirium. Awareness of a geographically variable and rapidly evolving drug supply is increasingly important for safe perioperative care."

Journal • Review • Anesthesia • Cardiovascular • CNS Disorders • Depression • Hypotension • Pain • Psychiatry

Opioid use and perioperative pain management practices in dogs and cats in Latvia: A national survey highlighting regional disparities and generational differences. (PubMed, Vet World) - "Butorphanol and buprenorphine were the most widely available opioids, whereas fentanyl and methadone availability was significantly associated with higher surgical caseloads (p < 0.01). The findings demonstrate broad adoption of evidence-based multimodal analgesia while identifying important regional inequalities in opioid availability and persistent underuse of standardized pain assessment tools. These results highlight priorities for continuing professional education, wider implementation of validated pain assessment methods, and improved access to essential analgesics to promote consistent, evidence-based pain management in veterinary practice."

Journal • Pain

Bilateral Sphenopalatine Ganglion Blocks in Adult Tonsillectomy and Uvulopalatopharyngoplasty: A Matched Retrospective Cohort Study (AAO-HNSF 2026) - "SPG block patients trended toward higher non-opioid analgesic use including acetaminophen (p=0.12), celecoxib (p=0.17), and gabapentin (p=0.10). There was no significant difference in hydromorphone, fentanyl, oxycodone, or morphine requirements between groups... SPG blocks in adults undergoing sleep surgery were safe and associated with trends toward increased non-opioid analgesic use. While immediate PACU pain scores did not differ, fewer block patients reported uncontrolled postoperative pain and/or required opioid refills after discharge, suggesting that SPG blocks may provide longer-lasting benefit beyond the immediate postoperative period."

Retrospective data