Excerpts from the MY-COMPASSION Expert Meeting
30 Jan 2019

BTcP is defined as: “A transient exacerbation of pain that occurs either spontaneously, or in relation to a specific predictable or unpredictable trigger, despite relatively stable and adequately controlled background pain”.1,2 While there are various pain profiles associated with BTcP, a BTcP episode is typically severe, reaching peak pain intensity within 1–3 minutes from onset and is short in duration (ie, subsiding within 30 minutes).2 In Malaysia, opioids such as oral immediate-release(IR), intravenous (IV) and subcutaneous (SC) morphine are prescribed as ‘rescue’ medications for BTcP.2 IR opioids reach peak concentrations around 1 hour post-administration,and have a half-life of 3–6 hours, which may be suitable for longer duration BTcP episodes, but may not sufficiently address ‘sharp’, short-duration BTcP.2 In contrast, the faster onset of action seen in ROOs (eg, SLF which reaches peak plasma concentrations within 30–60 minutes post-administration) may be better suited for such episodes of BTcP.3,4