Methadone in cancer pain treatment

Małgorzata Krajnik; Zbigniew Żylicz

Vol 1, No 1 (2002): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2002-05-07

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Methadone in cancer pain treatment

Małgorzata Krajnik, Zbigniew Żylicz

Advances in Palliative Medicine 2002;1(1):15-22.

Vol 1, No 1 (2002): Polish Palliative Medicine

Artykuły poglądowe

Published online: 2002-05-07

Abstract

In recent years, methadone has been increasingly used as the second-line opioid for treatment of pain in patients with cancer. The main barrier in wider use of this drug is probably due to its long half-life that could lead to accumulation and toxicity. Advantages are mostly consequences of the lack of active metabolites, good absorption by oral and rectal routes and the low cost of the drug. Rotation to methadone as a second line opioid may be more complex comparing to other opioids, because in opioid tolerant patients who are on higher doses of other opioids, methadone seems to have increased potency. Future trials should answer the question about the place of methadone as a first line opioid in cancer pain in some indications, in neuropathic pain and in patients who develop rapid tolerance to other opioids.