Methadone bioavailability and dose conversion implications with intravenous and enteral administration: A scoping review.
Purpose Despite its availability for more than 70 years, many details concerning methadone remain contentious, such as the dosing equivalents for intravenous and enteral administration. A scoping review was performed to evaluate whether existing literature on methadone bioavailability in human subje...
| Publicado en: | American Journal of Health-System Pharmacy Vol. 78; no. 15; pp. 1395 - 1402 |
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| Autores principales: | , , , , , , , |
| Formato: | research systematic review tables/charts Journal Article |
| Publicado: |
Oxford University Press / USA
Aug2021
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=151551984&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 151551984 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10792082 1X3 jtl: American Journal of Health-System Pharmacy issn: 10792082 maglogo: N pubinfo: dt: Aug2021 vid: 78 iid: 15 pid: 622 pub: Oxford University Press / USA artinfo: ui: 151551984 151551984 151551984 10.1093/ajhp/zxab166 151551984 ppf: 1395 ppct: 7 formats: fmt: @attributes: type: P tig: atl: Methadone bioavailability and dose conversion implications with intravenous and enteral administration: A scoping review. aug: au: Liu, JiTong Smith, Kathryn E Riker, Richard R Craig, Wendy Y McKelvy, Dina J Kemp, Heather D Nichols, Stephanie D Fraser, Gilles L affil: Department of Pharmacy, Critical Care, Maine Medical Center , Portland, ME , USA sug: subj: Methadone Administration and Dosage Administration, Intravenous Administration, Oral Methadone Pharmacokinetics Biological Availability Human Scoping Review PubMed Embase Narcotics Substance Use Disorders Drug Therapy Pain Descriptive Statistics Confidence Intervals Dosage Calculation ab: Purpose Despite its availability for more than 70 years, many details concerning methadone remain contentious, such as the dosing equivalents for intravenous and enteral administration. A scoping review was performed to evaluate whether existing literature on methadone bioavailability in human subjects support the current recommendation that an equivalent enteral dose is twice the intravenous dose. Methods A librarian-assisted search of the PubMed and EMBASE databases identified all English-language articles with the terms methadone and bioavailability and/or conversion in the title or abstract published from inception though December 2019. A manual search of references was also performed to identify any additional articles. Studies were included in a scoping review if they were published in English and evaluated methadone bioavailability in human subjects. Results Among 65 publications initially identified, 6 studies involving a total of 50 patients were included in the review. Bioavailability data for healthy volunteers and patients with opioid use disorder, metastatic cancer, chronic pain from malignant or nonmalignant disease were available for analysis. The pooled mean (95% confidence interval) bioavailability (F) was 85.4% (75.2%-95.6%), with heterogeneity (I 2) of 0. In the 4 studies that provided individual patient–level data, F was >50% in 40 of 42 patient measurements (95.2%) and ≥75% in 33 of 42 patient measurements (78.6%). Conclusion Available evidence suggests the bioavailability of methadone is generally more than 75%, there is limited evidence for the currently recommended 1:2 ratio (intravenous:enteral), and a more appropriate dosing ratio may be 1:1.3. This scoping review underscores the need for further research to establish an effective and safe ratio when converting between intravenous and enteral dosing formulations of methadone. pubtype: Academic Journal doctype: research systematic review tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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