Intranasal administration is a non-invasive route for
drug delivery, which is widely used for the local treatment of
rhinitis or nasal polyposis. Since drugs can be absorbed into the systemic circulation through the nasal mucosa, this route may also be used in a range of acute or
chronic conditions requiring considerable systemic exposure. Indeed, it offers advantages such as ease of administration, rapid onset of action, and avoidance of first-pass metabolism, which consequently offers for example an interesting alternative to intravenous, subcutaneous, oral transmucosal, oral or
rectal administration in the management of
pain with
opioids. Given these indisputable interests,
fentanyl-containing formulations have been recently approved and marketed for the treatment of breakthrough
cancer pain. This review will outline the relevant aspects of the therapeutic interest and limits of intranasal delivery of drugs, with a special focus on
opioids, together with an in-depth discussion of the physiological characteristics of the nasal cavity as well as physicochemical properties (lipophilicity, molecular weight, ionisation) and
pharmaceutical factors (absorption enhancers, devices for application) that should be considered for the development of nasal drugs.