MedicalResearch.com Interview with:
Sebastiano Mercadante, MD
Anesthesia and Intensive Care Unit and Pain Relief and Palliative Care Unit
La Maddalena Cancer Center
Department of Anesthesia, Intensive Care & Emergencies
University of Palermo
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: There are many clinical experiences suggesting that methadone, when optimally used by skilled physicians, has invaluable properties in the management of cancer pain. Methadone used as first opioid may provide interesting advantages due to the low tendency to induce tolerance, while providing a clinical profile similar to that of other opioids. Moreover, methadone possesses other extra-opioid effects that can be of interest.
MedicalResearch.com: What should readers take away from your report?
Response: Readers could be encouraged to use more frequently methadone, a cheap and convenient drug, that has be labelled as a difficult drug due to its pharmacokinetic characteristics. People who use methadone in their daily practice are very happy with its clinical effects even when it is used as first option at low levels of tolerance. Paradoxically, the use of low starting dose is easer than the use for opioid switching where conversion ratios, particularly in patients receiving high doses of opioids, may be problematic and require more experience.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Physicians should be encouraged to use methadone in their daily practice, may be utilizing it at low doses, to make experience and progressively improve their confidence with the drug even for other purposes. Further studies with appropriate design, particularly in the long-term period, may add further information on the feasibility of this drug in daily practice.
MedicalResearch.com: Is there anything else you would like to add?
Response: Methadone is a very convenient drug particularly in developing countries. I do not have any relationship with pharmaceutical industries for this drug.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
Methadone as first line opioid in cancer pain management: a systematic review
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