Pain Relief for Cancer Patients

A dose-adjustment program for oral methadone and the long-term effects of the analgesic therapy have been evaluated in 15 patients with incurable cancer. Rapid and continuous pain reliefwithout serious side-effects was achieved by "ad libitum" dosage in the first 3-5 days. Thereafter, a dosage based on each patient's subjective need was instituted. The mean daily dose was 44 mg during the first day and it decreased to 22 mg daily at the end of the dose-adjustment week. Three patients did not complete the program because of insufficient effect or severe nausea. Among the 12 patients who chose to continue the methadone treatment after the initial doseadjustment period, four continued the therapy to their death, three discontinued the therapy due to insullicient effect, and three due to adverse reactions. In one case it was possible to stop the treatment due to decreased pain. The treatment period in these 12 patients varied between 8 and 270 days. Oral methadone offers good pain relief for long periods of time in this group of patients and has obvious advantages as compared to long term parenteral therapy with narcotic analgesics.

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Clinical Evaluation of Oral Methadone in Treatment of Cancer Pain

Hansen

Ginman

Hartvig

et al. 1982

Acta Anaesthesiol Scand

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Patient-controlled dose regimen of methadone for chronic cancer pain.

Säwe¹,

Hansen²,

Ginman³

et al. 1981

BMJ

100

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Fourteen patients with severe cancer pain participated in a trial of methadone given in a fixed dose (10 mg) but at intervals selected by the patients themselves during the loading phase. The aim was to achieve rapid pain relief while avoiding the risk of toxicity from accumulation of methadone. As expected, the dosage intervals increased gradually over the first few days of treatment, the daily dose decreasing from 30-80 mg on the first day to 10-40 mg at the end of the week. Plasma concentrations of methadone varied sevenfold after four to five days (0 24 to 1-75 tmol/l; 7-4 to 54-2 ug/100 ml). Eleven patients reported complete or almost complete pain relief and elected to continue with methadone after the study. In no case was treatment withdrawn because of intoxication.From these findings a patient-controlled dosage regimen of oral methadone may be an effective and safe alternative to parenteral narcotic medication, adjusting both for individual variation in pain intensity and for pharmacokinetics.

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Pain Relief for Cancer Patients

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Clinical Evaluation of Oral Methadone in Treatment of Cancer Pain

Clinical Evaluation of Oral Methadone in Treatment of Cancer Pain

Patient-controlled dose regimen of methadone for chronic cancer pain.

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