Methadone
Methadone is a valuable opioid in the management of patients who have cancer with pain. Methadone is a mu-, kappa-, and delta-opioid agonist, and an N-methyl- D -aspartate receptor antagonist. These mechanisms of action make methadone an attractive option for complex pain syndromes. It is critically...
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| Published in: | Hematology/oncology clinics of North America Vol. 32; no. 3; pp. 405 - 415 |
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| Main Authors: | , , |
| Format: | Journal Article |
| Language: | English |
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01-06-2018
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| Abstract | Methadone is a valuable opioid in the management of patients who have cancer with pain. Methadone is a mu-, kappa-, and delta-opioid agonist, and an N-methyl- D -aspartate receptor antagonist. These mechanisms of action make methadone an attractive option for complex pain syndromes. It is critically important that providers consider a patient’s risk status before beginning methadone. Careful consideration must be given to dosing methadone in both opioid-naïve and opioid-tolerant patients, with vigilant monitoring for therapeutic effectiveness and potential toxicity until the patient achieves steady state. |
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| AbstractList | Methadone is a valuable opioid in the management of patients who have cancer with pain. Methadone is a mu-, kappa-, and delta-opioid agonist, and an N-methyl-D-aspartate receptor antagonist. These mechanisms of action make methadone an attractive option for complex pain syndromes. It is critically important that providers consider a patient’s risk status before beginning methadone. Careful consideration must be given to dosing methadone in both opioid-naïve and opioid-tolerant patients, with vigilant monitoring for therapeutic effectiveness and potential toxicity until the patient achieves steady state. |
| Author | McPherson, Alexandra L., PharmD, MPH Costantino, Ryan C., PharmD, BCPS, BCGP McPherson, Mary Lynn, PharmD, MA, MDE, BCPS, CPE |
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| Cites_doi | 10.1089/jpm.2009.0184 10.1634/theoncologist.2015-0503 10.1016/j.jpainsymman.2015.02.029 10.3109/15360288.2014.938883 10.1089/jpm.2013.0222 10.1185/03007995.2013.840568 10.1111/j.1526-4637.2008.00461.x 10.1089/jpm.2012.0612 10.1089/jpm.2016.0316 10.1089/jpm.2015.0525 10.1089/jpm.2014.0266 10.1089/jpm.2012.0335 10.1016/j.ejpain.2008.01.013 10.1002/chir.10303 |
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| Keywords | Opioid Cancer pain Methadone Analgesics Pain management |
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| References_xml | – volume: 16 start-page: 305 year: 2013 end-page: 309 ident: bib16 article-title: Addition of methadone to another opioid in the management of moderate to severe cancer pain: a case series publication-title: J Palliat Med contributor: fullname: Bryson – volume: 12 start-page: 1040 year: 2008 end-page: 1046 ident: bib6 article-title: Sustained-release oral morphine versus transdermal fentanyl and oral methadone in cancer pain management publication-title: Eur J Pain contributor: fullname: Ferrera – volume: 19 start-page: 1 year: 2016 end-page: 7 ident: bib19 article-title: Methadone as a coanalgesic for palliative care cancer patients publication-title: J Palliat Med contributor: fullname: Gagne – volume: 17 start-page: 8 year: 2016 end-page: 9 ident: bib13 article-title: Methadone safety guidelines for hospice and palliative care publication-title: AAHPM Quarterly contributor: fullname: McPherson – volume: 16 start-page: 60 year: 2015 end-page: 66 ident: bib3 article-title: Revisiting methadone: pharmacokinetics, pharmacodynamics and clinical indication publication-title: Rev Dor. São Paulo contributor: fullname: Garcia – volume: 50 start-page: 248 year: 2015 end-page: 259 ident: bib14 article-title: Methods of rotation from another strong opioid to methadone for the management of cancer pain: a systematic review of the available evidence publication-title: J Pain Symptom Manage contributor: fullname: Twomey – volume: 20 start-page: 656 year: 2017 end-page: 661 ident: bib8 article-title: Overall survival among cancer patients undergoing opioid rotation to methadone compared to other opioids publication-title: J Palliat Med contributor: fullname: de la Cruz – volume: 15 start-page: 321 year: 2014 end-page: 337 ident: bib9 article-title: Methadone safety: a clinical practice guideline from the American Pain Society and College of Problems on Drug Dependence, in collaboration with the Heart Rhythm Society publication-title: J Pain contributor: fullname: Fiellin – volume: 18 start-page: 114 year: 2015 end-page: 119 ident: bib18 article-title: The use of very-low-dose methadone and haloperidol for pain control in the hospital setting: a preliminary report publication-title: J Palliat Med contributor: fullname: Buckley – volume: 28 start-page: 197 year: 2014 end-page: 205 ident: bib1 article-title: Therapeutic challenges in cancer pain management: a systematic review of methadone publication-title: J Pain Palliat Care Pharmacother contributor: fullname: Movva – year: 2008 ident: bib25 article-title: Methadone safety handout for patients contributor: fullname: Leavitt – volume: 21 start-page: 981 year: 2016 end-page: 987 ident: bib7 article-title: Efficacy and safety of methadone as a second-line opioid for cancer pain in an outpatient clinic: a prospective open-label study publication-title: Oncologist contributor: fullname: Villavicencio-Chavez – volume: 16 start-page: 1 year: 2013 end-page: 7 ident: bib17 article-title: The use of very-low-dose methadone for palliative pain control and the prevention of opioid hyperalgesia publication-title: J Palliat Med contributor: fullname: Bruera – volume: 61 start-page: 493 year: 2012 end-page: 497 ident: bib2 article-title: Vital signs: risk for overdose from methadone used for pain relief – United States, 1999-2010 publication-title: MMWR Morb Mortal Wkly Rep contributor: fullname: Centers for Disease Control and Prevention – volume: 16 start-page: 36 year: 2004 end-page: 44 ident: bib5 article-title: Stereoselective metabolism of methadone N-demethylation by cytochrome P4502B6 and 2C19 publication-title: Chirality contributor: fullname: Gal – volume: 29 start-page: 1719 year: 2013 end-page: 1726 ident: bib11 article-title: QT interval prolongation and the risk of torsades de pointes: essentials for clinicians publication-title: Curr Med Res Opin contributor: fullname: Lien – volume: 16 start-page: 1382 year: 2013 end-page: 1387 ident: bib4 article-title: Methadone rotation for cancer patients with refractory pain in a palliative care unit: an observational study 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systematic review of methadone publication-title: J Pain Palliat Care Pharmacother doi: 10.3109/15360288.2014.938883 contributor: fullname: Good – volume: 16 start-page: 1382 issue: 11 year: 2013 ident: 10.1016/j.hoc.2018.01.004_bib4 article-title: Methadone rotation for cancer patients with refractory pain in a palliative care unit: an observational study publication-title: J Palliat Med doi: 10.1089/jpm.2013.0222 contributor: fullname: Rhondali – volume: 16 start-page: 60 issue: 1 year: 2015 ident: 10.1016/j.hoc.2018.01.004_bib3 article-title: Revisiting methadone: pharmacokinetics, pharmacodynamics and clinical indication publication-title: Rev Dor. São Paulo contributor: fullname: Neto – volume: 29 start-page: 1719 issue: 12 year: 2013 ident: 10.1016/j.hoc.2018.01.004_bib11 article-title: QT interval prolongation and the risk of torsades de pointes: essentials for clinicians publication-title: Curr Med Res Opin doi: 10.1185/03007995.2013.840568 contributor: fullname: Trinkley – volume: 9 start-page: 595 issue: 5 year: 2008 ident: 10.1016/j.hoc.2018.01.004_bib15 article-title: A systematic review of opioid conversion ratios used with methadone for the treatment of pain publication-title: Pain Med doi: 10.1111/j.1526-4637.2008.00461.x contributor: fullname: Weschules – volume: 16 start-page: 1 issue: 6 year: 2013 ident: 10.1016/j.hoc.2018.01.004_bib17 article-title: The use of very-low-dose methadone for palliative pain control and the prevention of opioid hyperalgesia publication-title: J Palliat Med doi: 10.1089/jpm.2012.0612 contributor: fullname: Salpeter – volume: 17 start-page: 8 issue: 2 year: 2016 ident: 10.1016/j.hoc.2018.01.004_bib13 article-title: Methadone safety guidelines for hospice and palliative care publication-title: AAHPM Quarterly contributor: fullname: McPherson – ident: 10.1016/j.hoc.2018.01.004_bib24 – volume: 20 start-page: 656 year: 2017 ident: 10.1016/j.hoc.2018.01.004_bib8 article-title: Overall survival among cancer patients undergoing opioid rotation to methadone compared to other opioids publication-title: J Palliat Med doi: 10.1089/jpm.2016.0316 contributor: fullname: Reddy – ident: 10.1016/j.hoc.2018.01.004_bib20 – volume: 11 start-page: 489 issue: 6 year: 2017 ident: 10.1016/j.hoc.2018.01.004_bib10 article-title: Methadone and the QTc interval: paucity of clinically significant factors in a retrospective cohort publication-title: J Addict Med contributor: fullname: Bart – volume: 19 start-page: 1 issue: 9 year: 2016 ident: 10.1016/j.hoc.2018.01.004_bib19 article-title: Methadone as a coanalgesic for palliative care cancer patients publication-title: J Palliat Med doi: 10.1089/jpm.2015.0525 contributor: fullname: Courtemanche – ident: 10.1016/j.hoc.2018.01.004_bib22 – volume: 61 start-page: 493 year: 2012 ident: 10.1016/j.hoc.2018.01.004_bib2 article-title: Vital signs: risk for overdose from methadone used for pain relief – United States, 1999-2010 publication-title: MMWR Morb Mortal Wkly Rep contributor: fullname: Centers for Disease Control and Prevention – volume: 18 start-page: 114 issue: 2 year: 2015 ident: 10.1016/j.hoc.2018.01.004_bib18 article-title: The use of very-low-dose methadone and haloperidol for pain control in the hospital setting: a preliminary report publication-title: J Palliat Med doi: 10.1089/jpm.2014.0266 contributor: fullname: Salpeter – year: 2008 ident: 10.1016/j.hoc.2018.01.004_bib25 contributor: fullname: Leavitt – volume: 16 start-page: 305 issue: 3 year: 2013 ident: 10.1016/j.hoc.2018.01.004_bib16 article-title: Addition of methadone to another opioid in the management of moderate to severe cancer pain: a case series publication-title: J Palliat Med doi: 10.1089/jpm.2012.0335 contributor: fullname: Wallace – volume: 12 start-page: 1040 year: 2008 ident: 10.1016/j.hoc.2018.01.004_bib6 article-title: Sustained-release oral morphine versus transdermal fentanyl and oral methadone in cancer pain management publication-title: Eur J Pain doi: 10.1016/j.ejpain.2008.01.013 contributor: fullname: Mercadante – volume: 15 start-page: 321 year: 2014 ident: 10.1016/j.hoc.2018.01.004_bib9 article-title: Methadone safety: a clinical practice guideline from the American Pain Society and College of Problems on Drug Dependence, in collaboration with the Heart Rhythm Society publication-title: J Pain contributor: fullname: Chou – volume: 16 start-page: 36 issue: 16 year: 2004 ident: 10.1016/j.hoc.2018.01.004_bib5 article-title: Stereoselective metabolism of methadone N-demethylation by cytochrome P4502B6 and 2C19 publication-title: Chirality doi: 10.1002/chir.10303 contributor: fullname: Gerber |
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| Snippet | Methadone is a valuable opioid in the management of patients who have cancer with pain. Methadone is a mu-, kappa-, and delta-opioid agonist, and an N-methyl-... Methadone is a valuable opioid in the management of patients who have cancer with pain. Methadone is a mu-, kappa-, and delta-opioid agonist, and an... |
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| SubjectTerms | Analgesics Cancer pain Hematology, Oncology, and Palliative Medicine Methadone Opioid Pain management |
| Title | Methadone |
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