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Old 10-14-2004, 02:47 PM   #1
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strength of methadone??????????

i'm really sorry about posting several times today but my previous question may be too difficult to amswer? simply put, in a comparison of the most common stronger opiates, where does methadone fall as far as strenght, say for instance compared to oc's, kadian,ms contin,etc. a simple comparison that i would understand is if i'm taking 60 mg's of methadone daily prescribed by my pain doc, what are the equivelents to the others???? i've suffered four complete rotor cuff tears in the last three years, all the same shoulder. waiting for complete reconstruction but my doc tells me this won't eliminate the pain either. most trauma suffered in the same area causes severe arthritis ans if anyone has ever popped a tendon completely you know what type of pain i'm talking about. they've tried to reattach it from partial tears as well over seven times in the last 15 years. most of the humeral bone has been cut off already and the rest is a mess of arthritis. this is to let everyone know why i've been taking my chronic meds.............

 
Old 10-14-2004, 03:53 PM   #2
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Re: strength of methadone??????????

I'm some will respond with some good info on switching meds that have prior experience/knowledge. As for me, I can only point you to this converter where you plug in what you are taking and the dose and it'll tell you the conversion. Of course, as everyone will tell you, everyone is different so even the conversions might not be accurate depending on the person.

[URL]www.globalrph.com/narcotic.cgi[/URL]

Last edited by Skott; 10-14-2004 at 03:56 PM.

 
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Old 10-14-2004, 03:57 PM   #3
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Re: strength of methadone??????????

Arggh, sorry can't seem to get it to post the link that you can just click on. You'll have to cut and paste the above address to get to the link.

Last edited by Skott; 10-14-2004 at 03:59 PM.

 
Old 10-18-2004, 09:56 AM   #4
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Re: strength of methadone??????????

When I swithed my docs use a 5:1 conversion,After a year on meth at 120mgs per day I went to 600mgs of Kadian, Kadian was dropped by my ins, plan and I went to generic MSC 200mgs TID and after a year on morphine I swithced back to the same 120 mgs of meth where I stayed for another year and a half.

You won't see a 5:1 conversion on anything but the most recent articles that suugest Meth has been underestimated for years and the equianelgesic tables are only acurate for single dose conversion. They do not take into acount the half life and build up of meth for the first 5 days.

Good luck, Dave

This is the conversion Dr Brookoff uses but you have to remeber, these are just guides to get you into the ballpark, they are safe so you won't OD and close enough to prevent withdrawal. But there is no absolute, you would likely still need adjutments unless you able to flip flop back and forth from one to the other.

Table 1. Equianalgesic
Doses of Opioid
Medications

Drug
Dose oral (mg)
Codeine 200mgs
Hydrocodone 40mgs
Hydromorphone 7.5mgs
Levorphanol 4mgs
Meperidine 300mgs
Methadone 20mgs
Morphine 60mgs
Oxycodone 30

This is the Unniversity of washingtons talarian index
Table 11. Dose equivalent for opioid analgesics for opioid-naive children and adults <50 KG BODY WEIGHT [1] Approximate equianalgesic dose

Morphine,
controlled-release
(MS Contin,Oramorph) =90-120 mg q 12 h
Hydromorphone (Dilaudid) =7.5 mg q 3-4 h
Levorphanol(Levo-Dromoran) =4 mg q 6-8 h
Meperidine(Demerol) = 300 mg q 2-3 h
Methadone(Dolophine, other) =20 mg q 6-8 h

Personally I think If you usd a 1:1 conversion on a partient using 600 mgs of morphine, and went to 600 mgs of methadone you would kill them in on the
2-3rd day
There just isn't an absolute answer, There is one more I'll be back to show.
Good luck, Dave

The chart below indicates the
Daily Oral Morphine Dose Equivalents
followed by the
Conversion Ratio of Oral Morphine to Oral Methadone

<100 mg - 3:1 (i.e., 3 mg morphine:1 mg methadone)

101-300 mg - 5:1

301-600 mg - 10:1

601-800 mg - 12:1

801-1000 mg - 15:1

>1001 mg - 20:1
Due to incomplete cross-tolerance, it is recommended that the initial dose is 50-75% of the equianalgesic dose.

Last edited by Shoreline; 10-18-2004 at 11:11 AM.

 
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