Intravenous methadone for cancer pain unrelieved by morphine and hydromorphone: clinical observations.


Journal Article

Methadone is a very effective second-line opioid for treatment of cancer pain. However, the starting doses of methadone indicated on opioid conversion charts may over-estimate the dose of intravenous (i.v.) methadone needed. In this report, we describe four patients with cancer-related pain treated with continuous i.v. morphine and hydromorphone. Because of persistent pain and opioid side effects limiting increases in opioid dose, each patient was switched to i.v. methadone. All four patients had excellent pain relief without significant side effects at a dose that, according to the available conversion charts, was approximately 3% of the calculated equianalgesic dose of hydromorphone. When converting from continuous i.v. hydromorphone to continuous i.v. methadone, much lower doses than those suggested by the opioid conversion charts should be used as starting doses.

Full Text

Cited Authors

  • Manfredi, PL; Borsook, D; Chandler, SW; Payne, R

Published Date

  • March 1997

Published In

Volume / Issue

  • 70 / 1

Start / End Page

  • 99 - 101

PubMed ID

  • 9106815

Pubmed Central ID

  • 9106815

International Standard Serial Number (ISSN)

  • 0304-3959

Digital Object Identifier (DOI)

  • 10.1016/s0304-3959(96)03313-1


  • eng

Conference Location

  • United States