Indian Journal of Palliative Care
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 ORIGINAL ARTICLE
Year : 2021  |  Volume : 27  |  Issue : 1  |  Page : 139--145

The use of methadone in adult patients with cancer pain at a governmental cancer center in India


1 Palliative Access (PAX) Program; Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre; Two Worlds Cancer Collaboration-INCTR, Vancouver, British Columbia, Canada
2 Faculty of Medicine, Lund University, Lund, Sweden
3 Department of Pediatric Palliative Care; Department of Pain Relief and Palliative Care Society, MNJ Institute of Oncology and Regional Cancer Centre, Vancouver, British Columbia, Canada
4 Department of Pain Relief and Palliative Care Society, MNJ Institute of Oncology and Regional Cancer Centre, Vancouver, British Columbia, Canada
5 Department of Radiology, MNJ Institute of Oncology and Regional Cancer Centre, Vancouver, British Columbia, Canada
6 Department of Pain and Palliative Medicine, MNJ Institute of Oncology and Regional Cancer Centre, Vancouver, British Columbia, Canada
7 Department of Clinical Sciences, Oncology and Pathology, Faculty of Medicine, Lund University; Department of Oncology, Skane University Hospital, Lund, Sweden
8 Department of Clinical Sciences, Oncology and Pathology, Institute for Palliative Care, Faculty of Medicine, Lund University; Department of Palliative Care and Advanced Home Health Care, Primary Health Care Skane, Region Skane, Lund, Sweden

Correspondence Address:
Mikael Segerlantz
Palliative Care and Advanced Home Health Care, Sankt Lars vag 90, 221 85 Lund
Sweden
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/IJPC.IJPC_275_20

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Background: Management of cancer-related pain relies on the access to opioids. When regular opioids as morphine are not tolerated or are insufficient, adjuvant opioids as methadone are an affordable and effective analgesic. Aim: The aim of the project was to describe the pattern of use and clinical experiences of methadone in patients with cancer-related pain at a low-resource hospital in Hyderabad, one of few Indian cancer centers with permission to prescribe methadone. Methods: Medical records of all patients who had been prescribed methadone, September 9, 2017 and November 19, 2019 were studied retrospectively. Data on analgesic treatment and opioid side effects were analyzed. Results: A total of 93 adult cancer patients were included in the study. A majority of patients (79%) were prescribed opioid analgesic, mainly morphine, before methadone introduction. The initial daily dose of methadone ranged between 5 and 22.5 years and in the vast majority of the patients 5 mg, divided in two daily administrations. A good analgesic effect, with decreased pain, was reported in 60% of the patients. No severe side effects were reported. Conclusions: In this study, methadone as a primary opioid was used with a good analgesic effect for cancer pain in a low-resource setting. Indication for methadone was mainly uncontrolled pain with a regular opioid treatment. No severe adverse effects were reported. Further research and prospective studies are needed on methadone treatment in low-resource settings to establish the robust guidelines to support prescribing physicians.






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