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Pain (PDQ®)

  • Updated: 09/03/2014

Table 2. Method 1: Initial Methadone Dose Based on Oral MEDDa

Oral MEDD (mg/d) Initial Dose Ratio (oral morphine:oral methadone) 
>1,00020:1 or greaterb

MEDD = morphine-equivalent daily dose.
aReprinted with permission from Fisch and Cleeland.[39]
bGreat caution must be used when converting to methadone when very high opioid doses have been used. Often, only a portion of the total opioid dose is converted initially, with further conversions taking place over several days to weeks.


  1. Fisch MJ, Cleeland CS: Managing cancer pain. In: Skeel RT, ed.: Handbook of Cancer Chemotherapy. 6th ed. Philadelphia, Pa: Lippincott Williams & Wilkins, 2003, pp 663.