Oral Methadone Dosing for Chronic Pain: A Practitioner’s Guide

Methadone has emerged as a good choice for the management of cancer pain and chronic non-cancer pain both as a first-line medication and as a replacement opioid. Particular cautions must be observed as methadone’s pharmacokinetics and pharmacodynamics are unique among opioids. Milligram for milligram, however, methadone is much more powerful than morphine, although there is significant interindividual variability in the response to methadone. In the initiation of chronic opioid therapy with methadone or the transition from a different opioid, careful day-to-day monitoring is essential. Methadone can interact with a large number of medications; therefore, drugdrug interactions must be considered. Finally, compared with other opioids, methadone can offer a very significant cost-savings advantage. This paper provides practical clinical guidance for all healthcare providers, whether or not they are already familiar with prescribing methadone for pain.


Author(s) Toombs, J.D.
Attribution Courtesy of Pain-Topics.org
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