Inpatient Transition from Methadone to Buprenorphine–Naloxone Using a Microdosing Strategy in a Postoperative Cancer Patient: A Case Report
Journal of Palliative Medicine April 30, 2024 Min Ji Kim, H. Walker, Matthew D Clark et al.
A postoperative cancer patient who was taking buprenorphine–naloxone for chronic noncancer pain and then switched to methadone for uncontrolled cancer-related pain successfully transitioned back to buprenorphine–naloxone using a microdosing strategy over one week in an inpatient setting. This approach avoided the need to reduce total opioid intake before starting buprenorphine, which is typically required to prevent precipitated withdrawal. The case suggests that microdosing may be a feasible method for transitioning from methadone to buprenorphine in patients who require higher opioid doses, such as those with cancer pain, though more research on its tolerability is needed.