June 2020 – Methadone…worth the trouble.
Don’t write off methadone as a pain medication – it may be life-changing for your palliative patients. A few reasons why:
Methadone is the only long-acting opioid that comes in a liquid.
For patients unable to swallow, sublingual absorption provides effective pain relief.
Methadone is the only opioid with significant effect on neuropathic pain.
Neuropathy, cancer pain, and visceral pain are good indications.
Methadone can be given in very small doses to limit the side effects.
Often, a dose of 2.5 mg at night can help frail elders with their constant daily pain.
Methadone is both less constipating and less sedating than other opioids.
But these side effects should be monitored.
If you aren’t a frequent methadone prescriber, don’t go it alone. There are dosing, drug interaction, Q-T prolongation, and conversion challenges with methadone. We are happy to help you consider and calculate a methadone dose for your palliative patients.