Methadone Use and the Risk of Hypoglycemia for Inpatients With Cancer Pain

Journal of Pain and Symptom Management
James H FloryNatalie Moryl

Abstract

Methadone is an important drug in the management of both cancer-related and non-cancer-related pain and is the main pharmacologic agent used in the treatment of opioid addiction. Unexpected hypoglycemia has been observed in patients receiving methadone, prompting a more detailed investigation. To evaluate the incidence of hypoglycemia in a cohort of inpatients receiving methadone versus other opioids including fentanyl, hydromorphone, and morphine. Retrospective observational cohort of inpatients in a tertiary cancer center admitted for more than 48 hours from November 1, 2011 to October 30, 2013. The main outcomes were lowest measured daily blood glucose (in mg/dL) and incidence of hypoglycemia (defined as blood glucose < 70 mg/dL, equivalent to 3.9 mmol/L) with variable methadone doses compared with other non-methadone opioids. Of the 641 eligible patients admitted during the study period who received at least one dose of methadone during admission, multivariable logistic regression showed significant associations between methadone and hypoglycemia at doses greater than 40 mg oral equivalents per day or with patient-controlled analgesia use. A dose-response relationship was observed, with an odds ratio of 3.1 (95% confidence ...Continue Reading

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Citations

Nov 18, 2017·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Umesh Masharani, Diana Alba
Nov 1, 2018·Journal of Medical Toxicology : Official Journal of the American College of Medical Toxicology·Michael S ToceEdward W Boyer
Jul 19, 2019·Expert Opinion on Drug Safety·Basile ChrétienXavier Humbert
Jul 31, 2019·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Jennifer L KoehlPatrick J Bridgeman
Apr 23, 2016·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists
Feb 6, 2017·International Journal of Nursing Practice·Maria Dolores Cano RomeroEtienne Mullet
Jun 27, 2017·Clinical Toxicology : the Official Journal of the American Academy of Clinical Toxicology and European Association of Poisons Centres and Clinical Toxicologists·Michael S ToceMichele M Burns
Jul 30, 2018·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Lisa NijlandBoris Zernikow

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