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Is Methadone Or Oxycontin Better For Chronic Pain?

Posted on Wed, 24 Aug 2016

Question: My brother is in the last stages of esophageal cancer. He discontinued his chemo and needs to be comfortable. He had a fall from a utility pole 14 yrs. ago and his two neck surgeries failed to improve his pain. He has been on 30mg of OxyContin 3 times daily for years and now is somewhat stable with Roxanol dosed 2 to 3 times daily PRN added to the OxyContin. The hospice RN wants to switch him to Methadone bid instead of the OxyContin. The hospice says they do not cover OxyContin (could be because he has Kaiser?)
She said Methadone is BETTER and affects more pain receptors then OxyContin. Does this sound appropriate for him in his last days. She also stated it would take a minimum of three days to reach therapeutic affect (so he needs to d/c the OxyContin)
Please give us some input,. Thanks XXXXX

Answered by Dr. Indranil Ghosh (6 hours later)

Brief Answer:
seems like a reasonable plan

Detailed Answer:
Hi
Thanks for your query.

Methadone is a good drug for pain relief, especially in terminally ill patients. It is long acting. Switching from oxycontin is absolutely fine. And the docs are correct in saying that the dose titration to achieve full pain control can take a few days.

I am sure he will do well on methadone.

Hope this helps.
Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar