The role of methadone in cancer pain treatment – a review

@article{Leppert2009TheRO,
  title={The role of methadone in cancer pain treatment – a review},
  author={Wojciech Leppert},
  journal={International Journal of Clinical Practice},
  year={2009},
  volume={63}
}
  • W. Leppert
  • Published 1 July 2009
  • Medicine, Psychology
  • International Journal of Clinical Practice
Background:  Methadone is an opioid analgesic of step 3 of the World Health Organization (WHO) analgesic ladder. 
Intravenous Opioid Agonists and Antagonists
The role of methadone in cancer-induced bone pain: a retrospective cohort study
TLDR
MR for CIBP may result in reduction in pain intensity, when other opioids are ineffective or intolerable, with patients requiring reduced overall dosing of their long-acting opioid and frequency of breakthrough opioid use.
Methadone for Pain Management in Children with Cancer
TLDR
There is support for the safety and efficacy of methadone in treating pain in children with cancer, particularly when pain is refractory to conventional treatment, but further evaluation with prospective studies is warranted to develop evidence-based recommendations.
Early Use of Methadone for Cancer Pain
TLDR
Methadone is a very interesting molecule for cancer pain treatment because of anti NMDA, SSRI and opioid actions, lack of active metabolite, and cost, but its benefits must be balanced against the potential drug to drug interactions during treatment initiation and interactions with other drugs when methadone doses are stable.
A Randomized Controlled Trial Evaluating the Analgesic Effect of the Combination of Methadone With Morphine for Cancer Related Pain
TLDR
Low dose of methadone in combination with morphine provided faster pain control as compared to morphine alone, and although this study was not powered to show differences in adverse effects, the authors did not notice a difference.
The role of methadone in pain treatment in cancer patients
TLDR
The mentioned advantages of methadone, especially high analgesic efficacy, low cost of the treatment and lack of significant immunosupressive effect causes that methamphetamineadone is an important alternative or complement to other opioids.
Methadone rotation for cancer pain: an observational study.
TLDR
Rotation to methadone according to the protocol is effective in achieving adequate analgesia in most patients experiencing nociceptive-neuropathic pain, and results suggest that a fixed equianalgesic ratio of 10:1 may be adequate for patients at low-to-moderate MEDD <400 mg/day.
Efficacy and Safety of Methadone as a Second-Line Opioid for Cancer Pain in an Outpatient Clinic: A Prospective Open-Label Study.
TLDR
The results of this study support the efficacy and safety of oral methadone as a second-line opioid in ambulatory patients with cancer and corroborate previously reported outcomes in retrospective outpatient studies and prospective studies that evaluated inpatient populations.
Methadone rotation for cancer patients with refractory pain in a palliative care unit: an observational study.
TLDR
The results suggest that methadone is effective and well tolerated for refractory cancer pain management in palliative care unit (PCU) inpatients.
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References

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Clinical pharmacology of methadone for pain
Background: This topical review addresses methadone's pharmacology, its application in malignant and non‐malignant pain conditions, practical issues related to methadone for the treatment of pain and
Intravenous methadone in the management of chronic cancer pain
TLDR
Patients often are rotated from other opioids to methadone when side effects occur before satisfactory analgesia is achieved, and there are no guidelines for estimating safe and effective starting doses of methad one when rotating from fentanyl.
Methadone for relief of cancer pain: a review of pharmacokinetics, pharmacodynamics, drug interactions and protocols of administration
Abstract Methadone, a synthetic opioid, has unique pharmacodynamics and pharmacokinetics, which contribute to its unique ability to relieve pain unresponsive to other potent opiates and its unique
Methadone analgesia for children with advanced cancer
TLDR
The objective of this study is to describe methadone use as primary opioid analgesic for advanced pediatric cancer over a 6.5‐year period.
Opioid rotation in patients with cancer pain: A retrospective comparison of dose ratios between methadone, hydromorphone, and morphine
TLDR
The purpose of this study was to review the analgesic dose ratios for methadone compared with hydromorphone and propose doses ranging from 1:6 to 1:10.
Methadone for cancer pain: What have we learned from clinical studies?
  • L. G. Soares
  • Medicine
    The American journal of hospice & palliative care
  • 2005
TLDR
The purpose of this review is to clarify a process for transitioning from morphine to methadone, and to answer some cancer pain-management issues.
Opioid switch to oral methadone in cancer pain
TLDR
Methadone, as an alternative to morphine, has been proposed in the control of opioid-induced toxicity, and its pharmacology, indications, and switching modalities are discussed here.
Dose ratio between morphine and methadone in patients with cancer pain
TLDR
The purpose of this study was to determine the equianalgesic dose ratio between morphine and methadone in patients with cancer pain and to establish whether the dose ratio changes as a function of previous opioid dose.
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