Abstract：
:Concerns about the safety of therapy with methadone, which may arise because of its pharmacokinetic characteristics and inappropriate dosing, may deter clinicians from using this drug, especially in elderly patients. Experience is accumulating that the drug may be used safely and successfully if low doses are given initially and care is taken in the titration of the dose against the pain. A prospective study was carried out in a consecutive sample of 45 advanced cancer patients followed at home, who had never received other strong opioids for their pain. Patients were treated with an oral liquid preparation of methadone, which was administered 2-3 times daily, according to need. Doses were kept as low as possible and were titrated to achieve acceptable analgesia with minimal adverse effects. The methadone starting dose (MSD) at referral, the maximum dose of methadone (MMD), the days of methadone treatment, the use of other nonopioid analgesics, symptoms associated with methadone therapy, pain intensity, and pain mechanism were recorded. Methadone escalation index percentage (MEI%) and methadone escalation index in mg (MEI mg) were calculated from these parameters. No correlations between age and gender, and MSD, MMD, days on methadone, VAS and symptoms were found. No significant differences were found in pain mechanisms, age, and other parameters, including methadone-related symptoms. Treatment of pain with methadone provides important support to patients with cancer followed at home and the risks are low with individually titrated doses, even in older patients or in the presence of a neuropathic pain mechanism.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Mercadante S,Casuccio A,Agnello A,Barresi Ldoi
10.1016/s0885-3924(99)00048-2subject
Has Abstractpub_date
1999-09-01 00:00:00pages
188-92issue
3eissn
0885-3924issn
1873-6513pii
S0885-3924(99)00048-2journal_volume
18pub_type
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,meta分析,评审
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
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journal_title：Journal of pain and symptom management
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