Controlled-release oxycodone tablets after transdermal-based opioid therapy in patients with cancer and non-cancer pain

2011 ◽  
Vol 23 (5-6) ◽  
pp. 328-332 ◽  
Author(s):  
Enrico Ravera ◽  
Salvatore Di Santo ◽  
Rosa Bosco ◽  
Claudio Arboscello ◽  
Renato Chiarlone
Keyword(s):  
Controlled Release ◽  
Cancer Pain ◽  
Opioid Therapy ◽  
Patients With Cancer

scholarly journals Compliance with Opioid Therapy: Distinguishing Clinical Characteristics and Demographics Among Patients with Cancer Pain

Pain Medicine ◽  
2017 ◽  
Vol 19 (7) ◽  
pp. 1469-1477 ◽  
Author(s):  
Dhanalakshmi Koyyalagunta ◽  
Eduardo Bruera ◽  
Mitchell P Engle ◽  
Larry Driver ◽  
Wenli Dong ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Clinical Characteristics ◽  
Opioid Therapy ◽  
Patients With Cancer

Randomized, double-blind, cross-over trial comparing safety and efficacy of oral controlled-release oxycodone with controlled-release morphine in patients with cancer pain.

1998 ◽  
Vol 16 (10) ◽  
pp. 3222-3229 ◽  
Author(s):  
E Bruera ◽  
M Belzile ◽  
E Pituskin ◽  
R Fainsinger ◽  
A Darke ◽  
...  
Keyword(s):  
Controlled Release ◽  
Cancer Pain ◽  
Treatment Preference ◽  
Dose Ratio ◽  
Double Blind ◽  
Patients With Cancer ◽  
Elimination Half ◽  
Global Ratings ◽  
History Of ◽  
Controlled Release Formulations

PURPOSE Use of oxycodone for chronic cancer pain has been hampered by its short elimination half-life. This study was designed to compare the efficacy and safety of controlled-release formulations of oxycodone and morphine for cancer pain. PATIENTS AND METHODS Thirty-two adult patients with cancer pain and a > or = 3-day history of stable analgesia with oral opioids provided written informed consent and were randomized to controlled-release oxycodone or controlled-release morphine for 7 days. To blind the study using available tablet strengths, the dose ratio of oxycodone to morphine was set at 1:1.5. On day 8, patients were crossed over to the alternate drug for 7 days. Pain intensity was assessed using a visual analog scale (VAS 0 to 100 mm) and a categorical scale (CAT 0 to 4). Side effects were assessed using a checklist (four-point categorical severity) and a nondirected questionnaire. Patients and investigators made blinded global ratings of efficacy and treatment preference. RESULTS Twenty-three patients completed the study (10 men, 13 women). The VAS and CAT scores were (mean+/-SD) 23+/-21 and 1.2+/-0.8 on controlled-release oxycodone, and 24+/-20 (P=.43) and 1.3+/-0.7 (P=.36) on controlled-release morphine. No period or carryover effect was detected. There were no significant differences in adverse effects (P=.40) or ratings of efficacy and preference. The median oxycodone/morphine dose ratio was 1.5 and the maximum was 2.3. CONCLUSION Controlled-release oxycodone is as safe and effective as controlled-release morphine in the treatment of cancer pain.

scholarly journals Prospective Association of Serum Opioid Levels and Clinical Outcomes in Patients With Cancer Pain Treated With Intrathecal Opioid Therapy

2020 ◽  
Vol 130 (4) ◽  
pp. 1035-1044 ◽  
Author(s):  
Shane E. Brogan ◽  
Jill E. Sindt ◽  
Carina M. Jackman ◽  
Julia White ◽  
Victoria Wilding ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Clinical Outcomes ◽  
Opioid Therapy ◽  
Patients With Cancer ◽  
Prospective Association

Role of Intravenous Ketamine as Adjuvant to Opioids in Refractory Cancer Pain: Case Report

2019 ◽  
Vol 3 (1) ◽  
pp. 49-53
Author(s):  
Yogesh Regmi ◽  
Ganga Sapkota ◽  
Bhawna Wagle
Keyword(s):  
Cancer Pain ◽  
Tissue Injury ◽  
Case Reports ◽  
Opioid Analgesics ◽  
Nmda Receptor Antagonist ◽  
Opioid Therapy ◽  
Chronic Stimulation ◽  
Patients With Cancer ◽  
Nociceptive Input

Cancer pain is caused by continuous tissue injury, which may be due to surgery, infiltration of the surrounding organs including nerves, as well as from mucositis after chemo- or radiotherapy. The pain experienced by cancer patients needs a multimodal approach, including ketamine. Nerve involvement, chronic opioid therapy and continuous nociceptive input cause hyperalgesia. Chronic stimulation of the dorsal root neurons leads to hyperalgesia and resistance (tolerance) to μ opioid analgesics (hyperalgesia-tolerance). The NMDA receptor antagonist ketamine reverses tolerance to morphine. The management of cancer patient’s pain with ketamine as an adjuvant to opioids is presented in case reports of two patients with cancer-related neuropathic pain, in which pain proved untreatable with the usual conventional pain therapies. Ketamine was administered IV route, in addition to morphine and the pain was controlled successfully in these patients. No side-effects were noted except drowsiness which responded to a reduction in the opioids dose.  

Clinical efficacy and safety of a novel controlled-release morphine suppository and subcutaneous morphine in cancer pain: a randomized evaluation.

1995 ◽  
Vol 13 (6) ◽  
pp. 1520-1527 ◽  
Author(s):  
E Bruera ◽  
R Fainsinger ◽  
K Spachynski ◽  
N Babul ◽  
Z Harsanyi ◽  
...  
Keyword(s):  
Controlled Release ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Clinical Efficacy ◽  
Oral Morphine ◽  
Mcgill Pain Questionnaire ◽  
Efficacy And Safety ◽  
Double Blind ◽  
Patients With Cancer ◽  
Significant Difference

PURPOSE A significant number of cancer patients will require an alternate route of morphine administration at some point during their illness. This study compared the clinical efficacy and safety of a novel morphine sulfate controlled-release suppository (MS-CRS) and subcutaneous (SC) morphine in patients with cancer pain. METHODS Thirty patients with cancer pain were randomized in a double-blind crossover study to MS-CRS every 12 hours or SC morphine every 4 hours for 4 days each, using a 2.5:1 analgesic equivalence ratio. Pain intensity was assessed using a visual analog scale (VAS) and the Present Pain Intensity Index of the McGill Pain Questionnaire. Nausea and sedation were also assessed with a VAS. Evaluations were made by the patient at 8 AM, noon, 4 PM, and 8 PM and rescue morphine consumption recorded. RESULTS Twenty-three patients completed the study (13 men and 10 women; mean age, 64.0 +/- 2.0 years) and were treated with mean daily MS-CRS and SC morphine doses of 326 +/- 69 mg and 138 +/- 28 mg, respectively. There was a small but significant difference in overall ordinal pain-intensity scores in favor of MS-CRS (0.7 +/- 0.1 v 0.9 +/- 0.1, P = .0459). There were no significant differences between MS-CRS and SC morphine in overall VAS scores for pain intensity (13 +/- 3 v 13 +/- 3 mm), sedation (23 +/- 3 v 25 +/- 4 mm), and nausea (8 +/- 2 v 9 +/- 2 mm). The mean daily rescue analgesic consumption during MS-CRS and SC morphine did not differ significantly (1.2 +/- 0.4 v 1.2 +/- 0.4 doses/d). CONCLUSION MS-CRS, administered every 12 hours, provides analgesia comparable to SC morphine and represents a reliable, noninvasive alternative method of pain control for patients unable to take oral morphine.

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