[introspectiveRN]

Originally Posted by erroridiot

There are more potent (and more effective) NSAIDS available at minimal cost for bridging the bone pain gap, such as Voltaren. A one month supply of this medication is available at Walmart/Sam's Club for $4/per 30 day supply.

Ultram and Naprosyn are also more potent than Ibuprofen.

When I am dying and in pain of any kind including bone, please do not give me Ibuprofen. It will not help.

hmmm.....well, ibuprofen has been very effective for the majority of my pts c bone mets/pain, esp when combined c dexamethasone.

[Em1995]

I've found ultram useless. All of my patients who used it complained that it didn't help them. And, Naprosyn has caused more stomach upset than Motrin. I still think that an anti-inflammatory combined with a long-acting pain med works the best.And, my patients also love how prednisone helps. So far, no one has complained about stomach upset from prednisone.I'm still curious about the methadone. Can anyone tell me the rationale for methadone used for bone pain? If it's more effective, I'd certainly consider it.
Thanks!

[earle58]

Originally Posted by Em1995

I'm still curious about the methadone. Can anyone tell me the rationale for methadone used for bone pain? If it's more effective, I'd certainly consider it.
Thanks!

methadone is effective and inexpensive.

but for bone pain, it's not practical.
duration of action is too long to allow easy changing of doses.
and there are too many other intermediate-acting narcotics, making it much more practical.

we use methadone a lot, for neuralgias...
only because this is the hardest type of pain to treat.
methadone works beautifully w/this type of pain.

but it's a last resort, usually.
titrating takes too much time:
not good, for someone that has immediate needs.

leslie

[Em1995]

Leslie and all....that's what I thought! I've found methadone to be very effective in neuropathic pain, but NEVER with bone pain. I thought maybe I had missed some new study! Whew!
Thanks!