Indication of Adequate Transdermal Fentanyl Dose in Opioid Switching From Oral Oxycodone in Patients With Cancer

Matsumura, Chikako; Yamada, Masami; Fujihara, Saki; Chisaki, Yugo; Takahashi, Kunitaro; Yano, Yoshitaka

doi:10.1177/1049909114554413

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…Similarly, Matsumura et al reported retrospective data from 122 patients, suggesting that the typical conversion OXpo:Ftd ratio was 95:1 but was significantly reduced in patients taking a daily oral morphine equivalent dose of <45 mg/d and in patients with poor pain control to 52:1 and 64:1, respectively (study using MEDD for conversion, not selected in our analysis). 56 …”

Section: Resultsmentioning

confidence: 99%

Practical management of opioid rotation and equianalgesia

Treillet¹,

Laurent²,

Hadjiat³

2018

JPR

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PurposeTo review the recent literature on opioid rotation (ie, switching from one opioid drug to another or changing an opioid’s administration route) in cancer patients experiencing severe pain and to develop a novel equianalgesia table for use in routine clinical practice.MethodsThe MEDLINE database was searched with terms “cancer pain,” “opioid rotation,” “opioid switching,” “opioid ratio,” “opioid conversion ratio,” and “opioid equianalgesia” for the major opioids (morphine, oxycodone, fentanyl, and hydromorphone) and the intravenous, subcutaneous, oral, and transdermal administration routes. Selected articles were assessed for the calculated or cited opioid dose ratio, bidirectionality, and use of the oral morphine equivalent daily dose or a direct drug-to-drug ratio.ResultsTwenty publications met our selection criteria and were analyzed in detail. We did not find any large-scale, prospective, double-blind randomized controlled trial with robust design, and most of the studies assessed relatively small numbers of patients. Bidirectionality was investigated in seven studies only.ConclusionThe updated equianalgesic table presented here incorporates the latest data and provides information on bidirectionality. Despite the daily use of equianalgesic tables, they are not based on high-level scientific evidence. More clinical research is needed on this topic.

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Section: Resultsmentioning

confidence: 99%