Showing Latest Articles
Switching from oxycodone to methadone in advanced cancer patients
Supportive Care in Cancer, 09/12/2011
Clinical Article
Mercadante S et al. – Switching from oxycodone to methadone is a reliable method to improve the opioid response in advanced cancer patients. A ratio of 3.3 appears to be reliable, even at high doses. Further studies should be performed to confirm these results in other settings and with very high doses of oxycodone.
Methods- Prospective study
- Cohort of consecutive sample of patients receiving oxycodone, who were switched for different reasons mainly because of an inconvenient balance between analgesia and adverse effects
- An initial conversion ratio between oxycodone and methadone was 3.3:1
- Intensity of pain and symptoms associated with opioid therapy were recorded, and distress score (DS) was also calculated as sum of symptom intensity
- Successful switching considered when intensity of pain and/or DS or the principal symptom requiring switching decreased at least of 33% of value recorded before switching
- 19 out of 542 patients admitted to the unit in 1 year underwent a switching from oxycodone to methadone. Almost all substitutions were successful
- Prevalent indication for opioid switching uncontrolled pain and adverse effects (12 patients)
- No significant changes between the initial conversion ratio and final conversion ratio between the 2 opioids were found
