Methadone analgesia.

[midazoslam]

Hi all,

Just wondering if anyone has had experience with methadone as an analgesic agent in a palliative setting? If so, how has it worked for your client? How is it monitored (particularly in community settings)? Have you still required adjuvants to assist with pain management?

I look forward to hearing from you all.

Midazoslam.

[PghRN15]

On the inpatient unit that I work on, I see a lot of patients that are on Methadone. It is excellent for bone pain. I generally see it prescribed around the clock and for break through. It is our policy that if someone is being converted to Methadone we do it on the inpatient unit vs. in the community. It's a good drug.

[midazoslam]

Thanks for all of your responses. It is a great analgesic it sounds like, however requires quite close monitoring too.

Can't wait until I can put all of this theory into practice!

[heron, ASN, RN]

It does. It's been a while, but I seem to remember that in my IPU we converted to methadone with a q6hr dosing schedule for a period of time to build up the cumulative effect and establish the daily total dose, then switched to q12hr doses. Hard to do in the field. (It's been a while.)

[rnin0513]

We use methadone a lot in cancer pain, especially bone pain. We usually start out very low (2.5mg bid) and overlap with their current pain meds for the initial loading 72hrs. I've had pts on as much as 120mg a day. Great alternative when MSSR isn't getting the job done.