The Use of Methadone in Pediatric Cancer Pain - A Retrospective Study from a Governmental Cancer Center in India

Overview

Journal Indian J Palliat Care

Specialty Critical Care

Date 2021 May 26

PMID 34035631

Citations 4

Authors

Gayatri Palat

Charlotte Algotsson

Spandana Rayala

Vikranth Haridass

Jayalatha Nethagani

Vineela Rapelli

Maria Gebre Medhin

Eva Brun

Mikael Segerlantz

Affiliations

Soon will be listed here.

Abstract

Background: The management of cancer-related pain relies on access to opioids. When regular opioids are not tolerated, or are insufficient, methadone is an affordable and effective analgesic.

Aim: The aim of the project was to describe the pattern of use and clinical experience of methadone in pediatric cancer pain at a governmental cancer hospital in Hyderabad, one of the four Indian cancer centers with permission to prescribe methadone.

Methods: This was a retrospective study of medical records of all children, under the age of 18, who had been prescribed methadone from September 9, 2017, to November 19, 2019. Data on analgesic effect, prior and concomitant analgesic treatment, opioid side effects, and the handling of methadone were analyzed.

Results: A total of 11 children were identified and studied. Methadone was introduced mainly when pain was uncontrolled by regular opioids. Initial daily doses ranged from 1 to 15 mg. The duration of treatment ranged from 7 to 307, with a median of 50 days in the nine patients where treatment exceeded one single dosage. Good analgesic effect was reported in 5/9 children, unchanged from previous analgesic treatment in three patients and without any effect in one child. No severe side effects were reported.

Conclusion: Low-dose methadone in the treatment of pediatric cancer pain at a low-resource cancer center was safe and well tolerated by the patients, with long treatment durations. It was safely managed, administered with single to double daily dosages, hence easy for patients and family to handle, and an affordable treatment option.

Citing Articles

A Narrative Review of Pain in Pediatric Oncology: The Opioid Option.

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PMID: 38954225 PMC: 11335799. DOI: 10.1007/s40272-024-00640-y.

Methadone for Cancer Pain Management in Children: A Review of Literature.

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PMID: 38324240 DOI: 10.1007/s40265-024-02001-y.

Old Drug, New Pain. Roles and Challenges of Methadone Therapy in Pediatric Palliative Care: A Systematic Review.

Benedetti F, Zoletto S, Salerno A, Avagnina I, Benini F Front Pediatr. 2022; 10:874529.

PMID: 35712616 PMC: 9196103. DOI: 10.3389/fped.2022.874529.

The Introduction and Experiences of Methadone for Treatment of Cancer Pain at a Low-resource Governmental Cancer Center in India.

Palat G, Algotsson C, Rayala S, Gebre-Medhin M, Brun E, Segerlantz M Indian J Palliat Care. 2021; 27(3):382-404.

PMID: 34898933 PMC: 8655673. DOI: 10.25259/IJPC_383_20.

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