Methadone in Hospice & Palliative Care

Appropriate Candidates:

 - Moderate to severe pain

 - Pain refractory to opioids

 - True phenanthrene allergy

 - Significant renal impairment

 - Needs a long acting opioid

 - High opioid tolerance

 - Neuropathic pain

 - Hx of dysphagia. inability to swallow etc

Inappropriate Candidates:

 - Patient lives alone. or poor cognitive functioning

 - Lack of primary care outpatient

 - History of opioid nonadherence

 - History of substance misuse

 - Multiple risk factors for methadone toxicty (ie clinical instability. transplant, TOC)

 - Hx of QTc prolongation or at high risk

 - Prognosis is less than projected time to methadone steady state



cindybobindy, PharmD, MPH @cindyPharMPH



#Methadone #Hospice #PalliativeCare #Pharmacology #Management