Comments on Pain-Topics.org News/Research UPDATES: Dosing Ratios: Morphine-to-Methadone Rotation

Thank you, for the note immediately above. We have...

2010-07-01T16:58:33.538-05:00

Thank you, for the note immediately above. We have also discussed opioid conversion and rotation issues in another blogpost [here], noting among other things that all of the automated conversion calculators have their own quirks and limitations that must be cautiously taken into account.

It may be prudent to access the conversion softwar...

2010-07-01T16:03:55.123-05:00

It may be prudent to access the conversion software available from the John Hopkins site if wanting to know conversion/switching to different opiates www.hopweb.org/. Their software programme gives instant conversion ie. 30mg oral methodone would equal 90mg morphine sulphate oral sustained release. It is worth a note- methodone(physeptone) has a 24 hour half life and is usually prescribed as a 24

Regarding the earlier comments above about convers...

2010-06-09T10:02:18.076-05:00

Regarding the earlier comments above about conversion ratios... there seems to be some confusion about morphine-to-methadone vs methadone-to-morphine ratios, and they are not interchangeable. We do not clearly understand what the comment authors are trying to say and we advise other readers to be cautious. Also, the usual time required to attain stability on methadone is 4 to 5 days but it can be

The question immediately above is important; howev...

2010-06-09T09:46:12.818-05:00

The question immediately above is important; however, we cannot respond (nor will we allow others to respond) to questions regarding individual patient health concerns. We cannot know all details of the patient's particular history and current status. And, we believe that second-guessing the clinical judgment of practitioners without knowing all of the details is inappropriate and can be very

I actually have a question. I have a friend in th...

2010-06-09T09:22:46.288-05:00

I actually have a question. I have a friend in the hospital undergoing chemo and radiation for esophogus cancer. He is and has been a methadone patient (for opiate addiction) for 3 years. He's on 125 mgs of Methadone a day and they are giving him a little extra for pain. They did have him on Dilaudid and Morphine in addition to the Methadone but has stopped the Dilaudid and Morphine and

If I read the information correclty, then we would...

2009-07-30T11:43:48.590-05:00

If I read the information correclty, then we would want to be more conservative when switching form Methadone to morphine so the conversion ration would not be 1:8 to 1:11 but would be even lower than the 1:4.7 conversion listed by Walker PW et al, 2008. Therefore, would it be recommended to possibly use a conversion ration of 1:1 to 1:3 when converting from methadone to morphine as to not over

If possible, I would like to hear some response on...

2009-07-30T09:13:44.715-05:00

If possible, I would like to hear some response on the conclusion above "Therefore, it would seem prudent to use a ratio for oral methadone to oral morphine of between approximately 1:8 to 1:11 as reported is some case reports by Lawlor et al, 1997 and Ripamonti et al, 1998. These reports were in patients with cancer. However, if treating chronic non-cancer pain it seems that this may also

In reference to the article “Conversion Ratios for...

2009-07-29T14:29:36.570-05:00

In reference to the article “Conversion Ratios for Rotation from Methadone to Other Opioids” in your “e-Briefing Newsletter” (2006, Vol 1, No 2, page 10). Go to: http://pain-topics.org/pdf/e-Briefing_Vol1_No2_2006.pdf and the primary article by Walker PW et al, 2008 Switching from methadone to a different opioid: what is the equianalgesic dose ratio? The ratio of oral methadone to oral morphine

In response to the question above -- according to ...

2009-07-28T11:49:12.030-05:00

In response to the question above -- according to the literature, numerous factors may influence the safety and tolerability of rotations from methadone to other opioids, including: patient age or gender, expected pain control, existing disease, concomitant medications, and genetic influences. For some preliminary recommendations on equianalgesic dosing, see the article, “Conversion

What type of a conversion ratio or morphine equiva...

2009-07-28T11:05:40.685-05:00

What type of a conversion ratio or morphine equivalent dose are you using when switching from methadone to morphine in a patient who has been receiving methadone for chronic pain.