Equianalgesic dose/ratio between methadone and other opioid agonists in cancer pain: Comparison of two clinical experiences
Background:Oral methadone is considered to be a valid opioid analgesic alternative to morphine and hydromorphone in treating cancer pain. However, the use of methadone could be complicated by the limited knowledge of the equianalgesic dose/ratio with the other analgesic opioids when switching in tol...
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| Veröffentlicht in: | Annals of oncology 1998-01, Vol.9 (1), p.79-83 |
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| container_title | Annals of oncology |
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| creator | Ripamonti, C. de Conno, F. Groff, L. Belzile, M. Pereira, J. Hanson, J. Bruera, E. |
| description | Background:Oral methadone is considered to be a valid opioid analgesic alternative to morphine and hydromorphone in treating cancer pain. However, the use of methadone could be complicated by the limited knowledge of the equianalgesic dose/ratio with the other analgesic opioids when switching in tolerant patients. Patients and methods:In two Palliative Care Units, data collected regarding 88 advanced cancer patients with pain switched from different opioids to oral methadone were reviewed and compared with the aim of determining the equianalgesic dose ratio in relation to the dose of opioid previously administered. Results:The results of this retrospective study suggest that: (1) methadone is much more potent than previously described in literature, (2) the dose ratio between hydromorphone and methadone is higher than as suggested by equianalgesic tables, and (3) the ratio correlates with total opioid dose administered before switching. Conclusions:The fact that methadone ratio is different according to the opioid dose used previously should be taken into careful consideration by the clinician in order to avoid severe toxicity or death during switchover. Prospective studies should be carried out in order to better define our findings. |
| doi_str_mv | 10.1023/A:1008263910494 |
| format | Article |
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However, the use of methadone could be complicated by the limited knowledge of the equianalgesic dose/ratio with the other analgesic opioids when switching in tolerant patients. Patients and methods:In two Palliative Care Units, data collected regarding 88 advanced cancer patients with pain switched from different opioids to oral methadone were reviewed and compared with the aim of determining the equianalgesic dose ratio in relation to the dose of opioid previously administered. Results:The results of this retrospective study suggest that: (1) methadone is much more potent than previously described in literature, (2) the dose ratio between hydromorphone and methadone is higher than as suggested by equianalgesic tables, and (3) the ratio correlates with total opioid dose administered before switching. Conclusions:The fact that methadone ratio is different according to the opioid dose used previously should be taken into careful consideration by the clinician in order to avoid severe toxicity or death during switchover. Prospective studies should be carried out in order to better define our findings.</description><identifier>ISSN: 0923-7534</identifier><identifier>EISSN: 1569-8041</identifier><identifier>DOI: 10.1023/A:1008263910494</identifier><identifier>PMID: 9541687</identifier><language>eng</language><publisher>Oxford: Oxford University Press</publisher><subject>Administration, Oral ; Adolescent ; Adult ; Aged ; Analgesics ; Analgesics, Opioid - therapeutic use ; Biological and medical sciences ; cancer ; Dose-Response Relationship, Drug ; equianalgesia ; Female ; Humans ; hydromorphone ; Hydromorphone - therapeutic use ; Linear Models ; Male ; Medical sciences ; methadone ; Methadone - therapeutic use ; Middle Aged ; Neoplasms - complications ; Neuropharmacology ; pain ; Pain - drug therapy ; Pain - etiology ; Pharmacology. Drug treatments ; Receptors, Opioid - agonists ; Retrospective Studies</subject><ispartof>Annals of oncology, 1998-01, Vol.9 (1), p.79-83</ispartof><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c471t-6af13eaf558729424f2af8c54f218038631754cdd8825188cddc2bde776e7d3f3</citedby><cites>FETCH-LOGICAL-c471t-6af13eaf558729424f2af8c54f218038631754cdd8825188cddc2bde776e7d3f3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,4022,27922,27923,27924</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2190150$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9541687$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ripamonti, C.</creatorcontrib><creatorcontrib>de Conno, F.</creatorcontrib><creatorcontrib>Groff, L.</creatorcontrib><creatorcontrib>Belzile, M.</creatorcontrib><creatorcontrib>Pereira, J.</creatorcontrib><creatorcontrib>Hanson, J.</creatorcontrib><creatorcontrib>Bruera, E.</creatorcontrib><title>Equianalgesic dose/ratio between methadone and other opioid agonists in cancer pain: Comparison of two clinical experiences</title><title>Annals of oncology</title><addtitle>Ann Oncol</addtitle><description>Background:Oral methadone is considered to be a valid opioid analgesic alternative to morphine and hydromorphone in treating cancer pain. However, the use of methadone could be complicated by the limited knowledge of the equianalgesic dose/ratio with the other analgesic opioids when switching in tolerant patients. Patients and methods:In two Palliative Care Units, data collected regarding 88 advanced cancer patients with pain switched from different opioids to oral methadone were reviewed and compared with the aim of determining the equianalgesic dose ratio in relation to the dose of opioid previously administered. Results:The results of this retrospective study suggest that: (1) methadone is much more potent than previously described in literature, (2) the dose ratio between hydromorphone and methadone is higher than as suggested by equianalgesic tables, and (3) the ratio correlates with total opioid dose administered before switching. Conclusions:The fact that methadone ratio is different according to the opioid dose used previously should be taken into careful consideration by the clinician in order to avoid severe toxicity or death during switchover. Prospective studies should be carried out in order to better define our findings.</description><subject>Administration, Oral</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Analgesics</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>cancer</subject><subject>Dose-Response Relationship, Drug</subject><subject>equianalgesia</subject><subject>Female</subject><subject>Humans</subject><subject>hydromorphone</subject><subject>Hydromorphone - therapeutic use</subject><subject>Linear Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>methadone</subject><subject>Methadone - therapeutic use</subject><subject>Middle Aged</subject><subject>Neoplasms - complications</subject><subject>Neuropharmacology</subject><subject>pain</subject><subject>Pain - drug therapy</subject><subject>Pain - etiology</subject><subject>Pharmacology. Drug treatments</subject><subject>Receptors, Opioid - agonists</subject><subject>Retrospective Studies</subject><issn>0923-7534</issn><issn>1569-8041</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpVkM1rVDEUxYModVpduxKycPucfL4k3Q2PfkGhVBTFTcjk3bTRmeSZvNKK_7wpMwx0dS6c37lwDkIfKPlMCePL1SklRLOeG0qEEa_QgsredJoI-hotiGG8U5KLt-i41l-EkN4wc4SOjBS012qB_p39eYguuc0d1OjxmCssi5tjxmuYHwES3sJ878acALs04jzfQ8F5ijmO2N3lFOtccUzYu-SbM7mYTvGQt5MrseaEc8DzY8Z-E1P0boPhaYISocH1HXoT3KbC-72eoG_nZ1-Hy-765uJqWF13Xig6d70LlIMLUmrFjGAiMBe0l02pJlz3nCop_DhqzSTVul2erUdQqgc18sBP0HL315dca4FgpxK3rvy1lNjnFe3KvlixJT7uEtPDegvjgd_P1vxPe9_VViqUVj7WA8aoIVSShnU7rI0ETwfbld-2V1xJe_njp_0-nN9-YReD5fw_hX2KrA</recordid><startdate>199801</startdate><enddate>199801</enddate><creator>Ripamonti, C.</creator><creator>de Conno, F.</creator><creator>Groff, L.</creator><creator>Belzile, M.</creator><creator>Pereira, J.</creator><creator>Hanson, J.</creator><creator>Bruera, E.</creator><general>Oxford University Press</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope></search><sort><creationdate>199801</creationdate><title>Equianalgesic dose/ratio between methadone and other opioid agonists in cancer pain: Comparison of two clinical experiences</title><author>Ripamonti, C. ; de Conno, F. ; Groff, L. ; Belzile, M. ; Pereira, J. ; Hanson, J. ; Bruera, E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c471t-6af13eaf558729424f2af8c54f218038631754cdd8825188cddc2bde776e7d3f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Administration, Oral</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Analgesics</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Biological and medical sciences</topic><topic>cancer</topic><topic>Dose-Response Relationship, Drug</topic><topic>equianalgesia</topic><topic>Female</topic><topic>Humans</topic><topic>hydromorphone</topic><topic>Hydromorphone - therapeutic use</topic><topic>Linear Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>methadone</topic><topic>Methadone - therapeutic use</topic><topic>Middle Aged</topic><topic>Neoplasms - complications</topic><topic>Neuropharmacology</topic><topic>pain</topic><topic>Pain - drug therapy</topic><topic>Pain - etiology</topic><topic>Pharmacology. Drug treatments</topic><topic>Receptors, Opioid - agonists</topic><topic>Retrospective Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ripamonti, C.</creatorcontrib><creatorcontrib>de Conno, F.</creatorcontrib><creatorcontrib>Groff, L.</creatorcontrib><creatorcontrib>Belzile, M.</creatorcontrib><creatorcontrib>Pereira, J.</creatorcontrib><creatorcontrib>Hanson, J.</creatorcontrib><creatorcontrib>Bruera, E.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><jtitle>Annals of oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ripamonti, C.</au><au>de Conno, F.</au><au>Groff, L.</au><au>Belzile, M.</au><au>Pereira, J.</au><au>Hanson, J.</au><au>Bruera, E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Equianalgesic dose/ratio between methadone and other opioid agonists in cancer pain: Comparison of two clinical experiences</atitle><jtitle>Annals of oncology</jtitle><addtitle>Ann Oncol</addtitle><date>1998-01</date><risdate>1998</risdate><volume>9</volume><issue>1</issue><spage>79</spage><epage>83</epage><pages>79-83</pages><issn>0923-7534</issn><eissn>1569-8041</eissn><abstract>Background:Oral methadone is considered to be a valid opioid analgesic alternative to morphine and hydromorphone in treating cancer pain. However, the use of methadone could be complicated by the limited knowledge of the equianalgesic dose/ratio with the other analgesic opioids when switching in tolerant patients. Patients and methods:In two Palliative Care Units, data collected regarding 88 advanced cancer patients with pain switched from different opioids to oral methadone were reviewed and compared with the aim of determining the equianalgesic dose ratio in relation to the dose of opioid previously administered. Results:The results of this retrospective study suggest that: (1) methadone is much more potent than previously described in literature, (2) the dose ratio between hydromorphone and methadone is higher than as suggested by equianalgesic tables, and (3) the ratio correlates with total opioid dose administered before switching. Conclusions:The fact that methadone ratio is different according to the opioid dose used previously should be taken into careful consideration by the clinician in order to avoid severe toxicity or death during switchover. Prospective studies should be carried out in order to better define our findings.</abstract><cop>Oxford</cop><pub>Oxford University Press</pub><pmid>9541687</pmid><doi>10.1023/A:1008263910494</doi><tpages>5</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Annals of oncology, 1998-01, Vol.9 (1), p.79-83 |
| issn | 0923-7534 1569-8041 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Administration, Oral Adolescent Adult Aged Analgesics Analgesics, Opioid - therapeutic use Biological and medical sciences cancer Dose-Response Relationship, Drug equianalgesia Female Humans hydromorphone Hydromorphone - therapeutic use Linear Models Male Medical sciences methadone Methadone - therapeutic use Middle Aged Neoplasms - complications Neuropharmacology pain Pain - drug therapy Pain - etiology Pharmacology. Drug treatments Receptors, Opioid - agonists Retrospective Studies |
| title | Equianalgesic dose/ratio between methadone and other opioid agonists in cancer pain: Comparison of two clinical experiences |
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