Switching methadone: a 10-year experience of 345 patients in an acute palliative care unit

Pain Medicine : the Official Journal of the American Academy of Pain Medicine
Sebastiano Mercadante

Abstract

The aim of this study was to retrospectively review the chart of cancer patients switched to methadone for unfavorable response to the previous opioid. Retrospective reviewed consecutive medical records of patients undergoing opioid switching to methadone were evaluated. Patients who were switched from different opioids to methadone, because of poor pain relief in the presence of adverse effects limiting further dose increases despite symptomatic treatment, were selected. After the initial oral dose, the subsequent doses were flexible and were changed timely to fit the patients' needs in an attempt to find the best balance between pain and opioid-related symptoms. Three hundred forty-five patients underwent switching to methadone. Twenty-seven patients were not considered feasible for analysis. Only one patient required the use of naloxone for the occurrence of bradypnea. A total of 77.4% substitutions for methadone were considered successful. The median time to achieve daily dose stabilization in patients successfully switched was 3 days. Fifty-one substitutions failed. For all previous opioids, no significant differences between initial conversion ratios and ratios achieved after stabilization were found (P = 0.42). No signif...Continue Reading

References

Oct 21, 1998·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·C RipamontiF De Conno
Oct 3, 1999·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·S MercadanteL Calderone
May 2, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·N ChernyUNKNOWN Expert Working Group of the European Association of Palliative Care Network
Jun 2, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·S MercadanteC Ripamonti
Feb 1, 2003·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Sebastiano MercadantePatrizia Ferrera
Jul 22, 2004·The Cochrane Database of Systematic Reviews·C Quigley
Nov 6, 2004·Cancer·Miguel Angel Benítez-RosarioJosé Javier Martín-Ortega
Jul 30, 2005·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·Sebastiano MercadanteAlessandra Casuccio
Aug 9, 2005·The American Journal of Hospice & Palliative Care·Sebastiano Mercadante, Edoardo Arcuri
Apr 21, 2006·Cancer Treatment Reviews·Sebastiano Mercadante, Eduardo Bruera
Jun 21, 2008·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Douglas J Weschules, Kevin T Bain
Dec 2, 2008·Journal of Pain & Palliative Care Pharmacotherapy·Jesús González-BarboteoXavier Gómez-Batiste
Jan 28, 2009·Journal of Pain and Symptom Management·Miguel Angel Benítez-RosarioManuel Feria
Apr 7, 2009·Journal of Pain and Symptom Management·Sebastiano MercadanteSalvatore Mangione
Jul 16, 2009·Current Medical Research and Opinion·Neal E Slatkin
Sep 9, 2009·Journal of Pain and Symptom Management·Helena KnotkovaRussell K Portenoy
Jul 30, 2010·Clinical Pharmacology and Therapeutics·H BuntenD Osselton
Oct 1, 2010·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Sebastiano MercadanteEdoardo Arcuri
Dec 16, 2010·Addiction Biology·Hannah BuntenMichael David Osselton
Mar 15, 2011·Pain·P KlepstadUNKNOWN European Association for Palliative Care Research Network
Apr 30, 2011·The American Journal of Hospice & Palliative Care·Valentina VitranoSebastiano Mercadante

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Citations

Mar 19, 2013·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Sebastiano MercadanteAmanda Caruselli
Aug 21, 2013·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Sebastiano MercadanteAlessandra Casuccio
Oct 16, 2013·Peptides·Richard J Bodnar
Jan 26, 2016·Critical Reviews in Oncology/hematology·Sebastiano Mercadante, Eduardo Bruera
Mar 30, 2016·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Gabriela P PeiranoGraciela Dran
Dec 11, 2014·Journal of Palliative Medicine·Shelley R SalpeterEduardo Bruera
Dec 21, 2016·Journal of Palliative Medicine·Akhila ReddyEduardo Bruera
Oct 31, 2015·British Journal of Pain·Sarah FalkAnthony H Dickenson
Jun 9, 2017·Journal of Palliative Medicine·Pippa HawleyMatthew Mittelstadt
Feb 5, 2019·Journal of Palliative Medicine·Sachiko OkayamaYoshito Yoshikawa
Oct 4, 2019·CNS Drugs·Sebastiano MercadanteAngela Santoni
Apr 11, 2013·Current Opinion in Supportive and Palliative Care·Sebastiano Mercadante
Feb 18, 2019·BMJ Supportive & Palliative Care·Bill LukinPhillip Good
Apr 15, 2015·Current Opinion in Supportive and Palliative Care·Kirsty Bannister
Jul 7, 2020·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Merlina SulistioNatasha Michael
Dec 21, 2013·Journal of Clinical Nursing·Sakuntala AnuruangPatricia M Davidson
Jul 12, 2017·Pain Practice : the Official Journal of World Institute of Pain·Johan HaumannMarieke H J van den Beuken-van Everdingen
Mar 23, 2018·Deutsches Ärzteblatt International·Michael SchusterRita Laufenberg-Feldmann
Apr 22, 2021·Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer·Guillermo MammanaGraciela Dran
Aug 3, 2021·Journal of Hospice and Palliative Nursing : JHPN : the Official Journal of the Hospice and Palliative Nurses Association·Sachiko Okayama, Yoshinobu Matsuda

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