Haider Ali, Reddy Akhila
Department of Palliative, Rehabilitation and Integrative Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
Ann Palliat Med. 2020 Mar;9(2):579-585. doi: 10.21037/apm.2020.02.01. Epub 2020 Feb 25.
Methadone has unique characteristics that make it an attractive agent for the treatment of chronic pain and opioid drug dependence. However, methadone prescription requires more clinical experience and close monitoring of patients to avoid its undesirable side effects. Recently, levorphanol has emerged as "a forgotten opioid" with a similar profile as methadone. Levorphanol has no impact on QTc prolongation and considerably less drug-drug interactions as compared to methadone. Lack of commercial availability, providers' unfamiliarity, and limited clinical data on its effectiveness remain practical issues. The objective of this article is to review and compare the safety considerations for methadone and levorphanol use.
美沙酮具有独特的特性，使其成为治疗慢性疼痛和阿片类药物依赖的有吸引力的药物。然而，美沙酮处方需要更多的临床经验并密切监测患者，以避免其不良副作用。最近，左啡诺作为“被遗忘的阿片类药物”出现，其特性与美沙酮相似。与美沙酮相比，左啡诺对QTc延长没有影响，药物相互作用也少得多。缺乏商业供应、提供者不熟悉以及其有效性的临床数据有限仍然是实际问题。本文的目的是回顾和比较美沙酮和左啡诺使用的安全注意事项。
