The successful use of parenteral methadone in a patient with a prolonged QTc interval.
Recent case reports have raised concerns about the potential for methadone to prolong the QTc interval (QT corrected for heart rate) and predispose patients to torsade de pointes (TdP), a life-threatening arrhythmia. We present a case report that describes the successful use of parenteral and oral methadone in a patient with uncontrolled cancer pain and a history of QTc prolongation. We describe an approach to the use of methadone in this patient and review both case reports and recent prospective studies that have evaluated the risk of TdP and the long-term outcome with respect to the development of TdP in patients receiving methadone for chronic pain or addiction.
Sekine
Ryuichi
R
Pain and Palliative Care Service, Memorial Sloan-Kettering Cancer Center, New York, NY, USA.
Obbens
Eugenie A M T
EA
Coyle
Nessa
N
Inturrisi
Charles E
CE
D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000150:complications; D006801:Humans; D007263:Infusions, Parenteral; D007680:Kidney Neoplasms / Q000150:complications; D008133:Long QT Syndrome / Q000150:complications* / Q000503:physiopathology; D008297:Male; D008691:Methadone / Q000008:administration & dosage* / Q000627:therapeutic use*; D008875:Middle Aged; D010148:Intractable Pain / Q000188:drug therapy* / Q000209:etiology; D010166:Palliative Care
D000701:Analgesics, Opioid; D008691:Methadone