{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T10:57:43Z","timestamp":1790074663375,"version":"4.0.1"},"reference-count":34,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2004,11,4]],"date-time":"2004-11-04T00:00:00Z","timestamp":1099526400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2004,12,15]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Patients with cancer often are rotated from other opioids to methadone to improve the balance between analgesia and side effects. To the authors' knowledge, no clear guidelines currently exist for the safe and effective rotation from transdermal fentanyl to methadone.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>The authors evaluated a protocol for switching opioid from transdermal fentanyl to oral methadone in 17 patients with cancer. Reasons for switching were uncontrolled pain (41.1% of patients) and neurotoxic side effects (58.9% of patients). Methadone was initiated 8\u201324 hours after fentanyl withdrawal, depending on the patient's previous opioid doses (from &lt; 100 \u03bcg per hour to &gt; 300 \u03bcg per hour). The starting methadone dose was calculated according to a 2\u2010step conversion between transdermal fentanyl:oral morphine (1:100 ratio) and oral morphine:oral methadone (5:1 ratio or 10:1 ratio). The correlation between previous fentanyl dose and the final methadone dose or the fentanyl:methadone dose ratio was assessed by means of Pearson and Spearman correlation coefficients (<jats:italic>r<\/jats:italic>), respectively. A Friedman test was used to compare pain intensity before and after the switch and the use of daily rescue doses.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Opioid rotation was fully or partially effective in 80% and 20%, respectively, of patients with somatic pain. Neuropathic pain was not affected by opioid switching. Delirium and myoclonus were reverted in 80% and 100% of patients, respectively, after opioid switching. A positive linear correlation was obtained between the fentanyl and methadone doses (Pearson <jats:italic>r<\/jats:italic>, 0.851). Previous fentanyl doses were not correlated with the final fentanyl:methadone dose ratios (Spearman <jats:italic>r<\/jats:italic>, \u2212 0.327).<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The protocol studied provided a safe approach for switching from transdermal fentanyl to oral methadone, improving the balance between analgesia and side effects in patients with cancer. Cancer 2004. \u00a9 2004 American Cancer Society.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.20712","type":"journal-article","created":{"date-parts":[[2004,11,12]],"date-time":"2004-11-12T16:20:07Z","timestamp":1100276407000},"page":"2866-2873","source":"Crossref","is-referenced-by-count":63,"title":["Opioid switching from transdermal fentanyl to oral methadone in patients with cancer pain"],"prefix":"10.1002","volume":"101","author":[{"given":"Miguel Angel","family":"Ben\u00edtez\u2010Rosario","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuel","family":"Feria","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Salinas\u2010Mart\u00edn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis Pedro","family":"Mart\u00ednez\u2010Castillo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Javier","family":"Mart\u00edn\u2010Ortega","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2004,11,4]]},"reference":[{"key":"e_1_2_5_2_2","doi-asserted-by":"crossref","first-page":"2542","DOI":"10.1200\/JCO.2001.19.9.2542","article-title":"Strategies to manage the adverse effects of oral morphine: an evidence\u2010based report","volume":"19","author":"Expert Working Group of the European Association of Palliative Care Network","year":"2001","journal-title":"J Clin Oncol."},{"key":"e_1_2_5_3_2","doi-asserted-by":"publisher","DOI":"10.1054\/bjoc.2001.1680"},{"key":"e_1_2_5_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19991101)86:9<1856::AID-CNCR30>3.0.CO;2-G"},{"key":"e_1_2_5_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00250-0"},{"key":"e_1_2_5_6_2","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.1999.430910.x"},{"key":"e_1_2_5_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0889-8588(02)00017-5"},{"key":"e_1_2_5_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2002.20.1.348"},{"key":"e_1_2_5_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(00)00277-3"},{"key":"e_1_2_5_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00327-X"},{"key":"e_1_2_5_11_2","doi-asserted-by":"crossref","first-page":"3213","DOI":"10.1200\/JCO.1998.16.10.3213","article-title":"Methadone in cancer pain management: individualize dose and titrate to effect","volume":"16","author":"Foley KM","year":"1998","journal-title":"J Clin Oncol."},{"key":"e_1_2_5_12_2","doi-asserted-by":"publisher","DOI":"10.2165\/00002512-199405060-00005"},{"key":"e_1_2_5_13_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.1999.17.10.3307"},{"key":"e_1_2_5_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(20011001)92:7<1919::AID-CNCR1710>3.0.CO;2-G"},{"key":"e_1_2_5_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.10518"},{"key":"e_1_2_5_16_2","doi-asserted-by":"publisher","DOI":"10.1191\/0269216303pm696oa"},{"key":"e_1_2_5_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3940(97)13391-2"},{"key":"e_1_2_5_18_2","doi-asserted-by":"publisher","DOI":"10.1089\/10966210252785097"},{"key":"e_1_2_5_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(95)90924-C"},{"key":"e_1_2_5_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.6.786"},{"key":"e_1_2_5_21_2","first-page":"331","volume-title":"Oxford textbook of palliative medicine","author":"Hanks GWC","year":"1998"},{"key":"e_1_2_5_22_2","doi-asserted-by":"publisher","DOI":"10.1191\/0269216302pm506xx"},{"key":"e_1_2_5_23_2","doi-asserted-by":"publisher","DOI":"10.1191\/026921601674921626"},{"key":"e_1_2_5_24_2","doi-asserted-by":"publisher","DOI":"10.1185\/030079902125001272"},{"key":"e_1_2_5_25_2","unstructured":"Janssen Pharmaceutica Products. 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