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Methadone for Pain Management in Children with Cancer

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Abstract

Methadone is a synthetic opioid with unique pharmacodynamic and pharmacokinetic properties. It is effective in treating both nociceptive and neuropathic pain, which commonly co-exist in children with cancer. Upon reviewing the literature describing the use of methadone in pediatric oncology patients, publications are limited in number and low in quality of evidence; nevertheless, there is support for the safety and efficacy of methadone in treating pain in children with cancer, particularly when pain is refractory to conventional treatment. Although the risk of life-threatening arrhythmia is commonly cited as an argument against the use of methadone, our review of the literature did not support this finding in children. Further evaluation with prospective studies is warranted to develop evidence-based recommendations for the use of methadone in pediatric oncology.

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Acknowledgements

The authors thank Dr. Vani Shanker for editing the manuscript.

Author information

Authors and Affiliations

  1. Divison of Hospitalist Medicine, Department of Pediatrics, Children’s National Medical Center, Washington, DC, 20010, USA

    Catherine Habashy

  2. Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins Hospital, Baltimore, MD, 21287, USA

    Erin Springer

  3. Pharmaceutical Services, St. Jude Children’s Research Hospital, Memphis, TN, 38105, USA

    Elizabeth A. Hall

  4. Division of Anesthesia, Department of Pediatric Medicine, St. Jude Children’s Research Hospital, Memphis, TN, 38105, USA

    Doralina L. Anghelescu

Authors
  1. Catherine Habashy
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  2. Erin Springer
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  4. Doralina L. Anghelescu
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Corresponding author

Correspondence to Doralina L. Anghelescu.

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Conflict of interest

Catherine Habashy, Erin Springer, Elizabeth A. Hall, and Doralina L. Anghelescu have no conflicts of interest.

Funding

No funding was received for the systematic review or the preparation of the manuscript.

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Habashy, C., Springer, E., Hall, E.A. et al. Methadone for Pain Management in Children with Cancer. Pediatr Drugs 20, 409–416 (2018). https://doi.org/10.1007/s40272-018-0304-2

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  • DOI: https://doi.org/10.1007/s40272-018-0304-2

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