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 |
| MEDD = morphine-equivalent daily dose. | |
| aReprinted with permission from Fisch and Cleeland.[39] | |
| 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. |
References
- 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.
