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Table 2. Method 1: Initial Methadone Dose Based on Oral MEDDa
|
Oral MEDD (mg/d)
|
Initial Dose Ratio (oral morphine:oral methadone)
|
| <30 |
2:1 |
| 30–99 |
4:1 |
| 100–299 |
8:1 |
| 300–499 |
12:1 |
| 500–999 |
15:1 |
| >1,000 |
20:1 or greaterb |
|
aReprinted with permission from Fisch and Cleeland.[41]
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bGreat caution must be used when converting to methadone when very high opioid doses have been used. Often, only a portion of the total opioid dose is converted initially, with further conversions taking place over several days to weeks.
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References
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Fisch MJ, Cleeland CS: Managing cancer pain. In: Skeel RT, ed.: Handbook of Cancer Chemotherapy. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2003, pp 663.
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