Table 2. Method 1: Initial Methadone Dose Based on Oral MEDDa
|Oral MEDD (mg/d)||Initial Dose Ratio (oral morphine:oral methadone)|
|>1,000||20:1 or greaterb|
|MEDD = morphine-equivalent daily dose.|
|aReprinted with permission from Fisch and Cleeland.|
|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.|
- 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.