We use a 3 to 1 ratio that is consistent with CMS, the State of Oregon PDMP, and research studies by Von Korff (Clin J Pain 2008 24:521-7) and Krebs (Pain 2011 152:1789-95). There is limited evidence and no consensus on the conversion factors to use for methadone. ![]() Increasing methadone doses over 30 mg/day is not recommended. Methadone should not be the first choice for an ER/LA opioid. It may be appropriate, according to clinical judgment, to initiate some patients on. In addition, methadone is associated with cardiac arrhythmias along with QT prolongation on the electrocardiogram. Enter total daily dosage: mg The 50, 75, and 100 mcg/hr patches should only be used in patients already on and tolerant to opioid therapy. The initial dose of DURAGESIC should be obtained from the conversion tables in DOSAGE AND ADMINISTRATION, and must Unot U be higher than that dose which is equivalent to the total dose of opioids the patient is receiving at the time of the switch to the patch. One fentanyl 100mcg / hour transdermal patch applied every 3 days is the equivalent of 300mg of morphine orally daily. ![]() Methadone has been associated with disproportionate numbers of overdose deaths relative to the frequency with which it is prescribed for chronic pain, due in part to its long and variable half-life.
0 Comments
Leave a Reply. |