Pain Management

Cancer Pain Management

How to switch from morphine or oxycodone to methadone in cancer patients? A randomised clinical phase II trial

Moksnes K, Dale O, Rosland JH, et al (Norwegian Univ of Science and Technology (NTNU), Trondheim, Norway; Haraldsplass Deaconess Hosp, Bergen, Norway) Eur J Cancer 47:2463-2470, 2011^§

Abstract

Aim

Opioid switching is a treatment strategy in cancer patients with unacceptable pain and/or adverse effects (AEs). We investigated whether patients switched to methadone by the stop and go (SAG) strategy have lower pain intensity (PI) than the patients switched over three days (3DS), and whether the SAG strategy is as safe as the 3DS strategy.

Methods

In this prospective, open, parallel-group, multicentre study, 42 cancer patients on morphine or oxycodone were randomised to the SAG or 3DS switching-strategy to methadone. The methadone dose was calculated using a dose-dependent ratio. PI, AEs and serious adverse events (SAEs) were recorded daily for 14 days. Primary outcome was average PI day 3. Secondary outcomes were PI now and AEs day 3 and 14 and number of SAEs.

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