Dextropropoxyphene versus morphine in opioid-naive cancer patients with pain.
The role of opioids for moderate pain (so-called "weak" opioids) in the second step of the World Health Organization's analgesic ladder has been investigated in a prospective randomized study. Sixteen patients were administered dextropropoxyphene (DPP) in a dosage ranging from 120 mg to 240 mg daily (group 1), and 16 patients were administered the lowest doses (20 mg daily) of commercially available controlled-release morphine (group 2). Equianalgesic doses of oral morphine, pain relief, and symptoms during the first 10 days of therapy and during the last 4 weeks before death were assessed. Three of 16 patients maintained DPP until death, whereas three patients in group 2 were switched to DPP due to the occurrence of intolerable side effects. Intensity and frequency of nausea and vomiting, drowsiness, and dry mouth were higher in group 2 than in group 1 during the initial treatment. These results stress the role of "weak" opioids during the induction of opioid therapy in opioid-naive cancer patients.
Mercadante
S
S
Department of Anesthesia and Intensive Care, Buccheri La Ferla Fatebenefratelli Hospital, Palermo, Italy.
Salvaggio
L
L
Dardanoni
G
G
Agnello
A
A
Garofalo
S
S
D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D011431:Dextropropoxyphene / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use*; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy*; D011446:Prospective Studies
D000701:Analgesics, Opioid; D009020:Morphine; D011431:Dextropropoxyphene