What is it about?
A simple, mathematically sound, method for conversion of oral morphine equivalents to methadone. OF course, other factors other than just initial dose are important in methadone dosing for chronic pain so this method should only be used by providers experienced in methadone use AND after validation by an independent study.
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Why is it important?
Methadone is a very useful medication that suffers from lack of a simple, validated conversion method.
Perspectives
Previous methods have been klunky or don't apply across the board. We tried to find a single, simple formula that would give the correct results. We believe we succeeded.
Dr Steven J Baumrucker
Wellmont Health System
Read the Original
This page is a summary of: A new mathematical approach to methadone conversion, Journal of Pharmacology and Pharmacotherapeutics, January 2016, Medknow,
DOI: 10.4103/0976-500x.184773.
You can read the full text:
Resources
Morphine to methadone conversion: an interpretation of published data.
For the past 20 years, methadone has been experiencing resurgence in the palliative care community as a second-line opioid for the treatment of cancer pain. The advantages of using methadone for refractory pain in patients with cancer or in those who could not tolerate the side effects of other opioids such as morphine are well cited in recent literature. Advantages of methadone over other opioids include dual elimination without active metabolites, allowing safe use with renal and liver failure, N-methyl-D-aspartate (NMDA) and delta receptor activity in addition to mu receptor agonism, multiple routes of administration, rapid onset of action, long half-life, low cost, and fewer adverse effects. Despite the abundance of recent case reports and literature reviews demonstrating the effective use of methadone in patients with cancer, there is a lack of consensus for an appropriate method for converting morphine (and by extension, other opioids) to methadone. This article will review methadone pharmacology and multiple proposed conversion methods; a case report illustrating a popular method for high-dose conversion is also included.
Politics, cancer pain, and methadone.
Editorial regarding lack of access to methadone.
Contributors
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