title: Extreme doses of intravenous methadone for severe pain in two children with cancer.
abstract: We describe the effect and side effects in two children with cancer treated with intravenous methadone in extreme doses (>10 mg/kg/day) due to vincristine-induced neuropathy where surgical procedures provoked severe neuropathic pain. The maximum daily dose was 33 and 25 mg/kg/day. Methadone remained effective at adjusted doses. Few side effects were reported. No significant changes in paraclinical data were observed. Prolonged QTc-interval occurred only during concomitant treatment with fluconazole. In conclusion, methadone should be seen as a part of the armamentarium against cancer-related pain. Methadone can be used in extreme doses with appropriate monitoring by clinicians experienced in its use.
authors: Department of Pediatrics, Aarhus University Hospital Skejby, Denmark.
authors: Vinni Faber
authors: VF
authors: Rasmussen
authors: Vicki
authors: V
authors: Lundberg
authors: Torben Worsøe
authors: TW
authors: Jespersen
authors: Henrik
authors: H
authors: Hasle
mesh_terms: D000293:Adolescent; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D002648:Child; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D009369:Neoplasms / Q000503:physiopathology*; D010148:Intractable Pain / Q000188:drug therapy*
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: QT prolongation; methadone; neuropathic pain; opioid rotating; pain medicine; palliative care; supportive care