Prescribing Abstral (fentanyl as citrate): PBS information

Published 8th May 2026

HCP Resource

Abstral

	INITIAL TREATMENT FOR DOSE TITRATION		CONTINUING TREATMENT
	TREATMENT PHASE¹
Strengths	100 µg and 200 µg only	300 µg, 400 µg, 600 µg and 800 µg	100 µg, 200 µg, 300 µg, 400 µg, 600 µg and 800 µg
Quantity (number of tablets)	20 (2 x 10-pack)	10	60 (2 x 30-pack)
Increased quantities available	No	No	No
Max Repeats (written prescription sent to Department of Human Services for approval)	0	0	2#
Prescriber	Medical Practitioner/Nurse Practitioner

#For the first continuing supply, applications for increased repeats for up to 3 months’ supply may be authorised.

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…or something like this:

	INITIAL TREATMENT FOR DOSE TITRATION		CONTINUING TREATMENT
	TREATMENT PHASE¹
Strengths	100 µg and 200 µg only	300 µg, 400 µg, 600 µg and 800 µg	100 µg, 200 µg, 300 µg, 400 µg, 600 µg and 800 µg
Quantity (number of tablets)	20 (2 x 10-pack)	10	60 (2 x 30-pack)
Increased quantities available	No	No	No
Max Repeats (written prescription sent to Department of Human Services for approval)	0	0	2#
Prescriber	Medical Practitioner/Nurse Practitioner

#For the first continuing supply, applications for increased repeats for up to 3 months’ supply may be authorised.

Where consultation with a palliative care specialist or service has occurred, applications for increased repeats for up to 3 months’ supply may be authorised.

Telephone approvals are limited to 1 month’s therapy.

Patient must have cancer; AND
Patient must have pain directly attributable to cancer; AND
Patient must be assessed as receiving adequate management of their persistent pain with opioids; AND
Patient must have previously experienced inadequate pain relief following adequate doses of short acting opioids for the treatment of breakthrough pain; OR
The treatment must be used as short acting opioids are considered clinically inappropriate; OR
Patient must have previously experienced adverse effects following the use of short acting opioids for breakthrough pain.

Patient must be undergoing palliative care.

Caution: The risk of drug dependence is high

Abstral is indicated for the management of breakthrough pain in adults with cancer who are already receiving maintenance opioid therapy for chronic pain.²

Pharmaceutical Benefits Scheme (PBS). Available at: https://www.pbs.gov.au. Accessed April 2026.
Abstral Approved Product Information

Please refer to the statement regarding the responsible use of opioid-based medicines before prescribing. The full up-to-date statement can be accessed via HERE

PBS Information: Authority required for the treatment of breakthrough pain. Refer to PBS Schedule for full authority information.

Please review the Approved Product Information before prescribing. The Product Information can be accessed via HERE

WARNINGS – Limitations of Use – Because of the risks associated with the use of opioids, Abstral should only be used in patients for whom other treatment options, including non-opioid analgesics, are ineffective, not tolerated or otherwise inadequate to provide appropriate management of pain. Hazardous and harmful use – Abstral poses risks of hazardous and harmful use which can lead to overdose and death. Assess the patient’s risk before prescribing and monitor regularly during treatment. Life threatening respiratory depression – Serious, life-threatening or fatal respiratory depression may occur with Abstral. Modify dosing and monitor at-risk patients closely, especially on initiation or after dose increase. Concomitant use of benzodiazepines and other CNS depressants, including alcohol, may result in profound sedation, respiratory depression, coma, and death. Use the minimum effective dose and treatment duration and monitor for respiratory depression and sedation. Caution patients not to drink alcohol. See approved PI.

Prescribing Abstral (fentanyl as citrate): PBS information

Clinical criteria

Treatment criteria

References