OPIOID-SPARING EFFECT OF DICLOFENAC IN CANCER

This study investigated the opioid-sparing effect of diclofenac using patient-controlled analgesia with oral methadone. Fifteen patients wit h advanced cancer participated. After achieving adequate analgesia wit h regular dosing of oral methadone (T1), patient-controlled analgesia with methadone was administered for 3 days (T2). Intramuscular diclofe nac 75 mg twice daily was then added to this regimen for 3 days (T3). Compared to T2 values, methadone dose was significantly reduced at T2 and T2, and pain report (recorded on a visual analogue scale) was sign ificantly reduced at T3. A reduction in methadone plasma concentration was also observed at T2 and T3, although it did not attain statistica l significance. Significant decreases in the intensity of several symp toms other than pain were also found at T2 and T3. Diclofenac appears to have a relevant opioid-sparing effect when using patient-controlled analgesia with oral methadone. (C) U.S. Cancer Pain Relief Committee, 1997.