ReviewJournal of pain research2014
Toward a systematic approach to opioid rotation.
Review in Journal of pain research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 72 citations in OpenAlex.
- Opioid conversion in adults with cancer: MASCC-ASCO-AAHPM-HPNA-NICSO guideline.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Guideline
- Opioid switching and variability in response in pain cancer patients.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019Trial
- Bioequivalence, Drugs with Narrow Therapeutic Index and The Phenomenon of Biocreep: A Critical Analysis of the System for Generic Substitution.Healthcare (Basel, Switzerland) · 2022Review
- An Investigation into Proteomic Constituents of Cerebrospinal Fluid in Patients with Chronic Peripheral Neuropathic Pain Medicated with Opioids- a Pilot Study.Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology · 2021Article
- Mechanisms, diagnosis, prevention and management of perioperative opioid-induced hyperalgesia.Pain management · 2021Article
- A Practical Approach to Acute Postoperative Pain Management in Chronic Pain Patients.Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses · 2020Article
- Improving quality in colon and rectal surgery through palliative care.Seminars in colon & rectal surgery · 2020Article
- Inhibition of fatty acid amide hydrolase in the CNS prevents and reverses morphine tolerance in male and female mice.British journal of pharmacology · 2020Article
- Substance use disorders: diagnosis and management for hospitalists.Journal of community hospital internal medicine perspectives · 2020Review
- Alleviating pain with delta opioid receptor agonists: evidence from experimental models.Journal of neural transmission (Vienna, Austria : 1996) · 2020Review
- Consensus Statement for the Prescription of Pain Medication at Discharge after Elective Adult Surgery.Canadian journal of pain = Revue canadienne de la douleur · 2020Article
- A G protein signaling-biased agonist at the μ-opioid receptor reverses morphine tolerance while preventing morphine withdrawal.Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology · 2020Article
- Synthesis and Pharmacological Evaluation of Hybrids Targeting Opioid and Neurokinin Receptors.Molecules (Basel, Switzerland) · 2019Article
- Comprehensive molecular pharmacology screening reveals potential new receptor interactions for clinically relevant opioids.PloS one · 2019Article
- Advances in pain management for older patients with cancer.Ecancermedicalscience · 2019Review
- Article
- Targeting multiple opioid receptors - improved analgesics with reduced side effects?British journal of pharmacology · 2018Review
- Effectiveness and Safety of Once-Daily Extended-Release Hydrocodone in Individuals Previously Receiving Immediate-Release Oxycodone for Chronic Pain.Pain medicine (Malden, Mass.) · 2018Article
- Opioids and Cardiac Arrhythmia: A Literature Review.Medical principles and practice : international journal of the Kuwait University, Health Science Centre · 2018Review
- The use of rotation to fentanyl in cancer-related pain.Journal of pain research · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Patients requiring chronic opioid therapy may not respond to or tolerate the first opioid prescribed to them, necessitating rotation to another opioid. They may also require dose increases for a number of reasons, including worsening disease and increased pain. Dose escalation to restore analgesia using the primary opioid may lead to increased adverse events. In these patients, rotation to a different opioid at a lower-than-equivalent dose may be sufficient to maintain adequate tolerability and analgesia. In published trials and case series, opioid rotation is performed either using a predetermined substitute opioid with fixed conversion methods, or in a manner that appears to be no more systematic than trial and error. In clinical practice, opioid rotation must be performed with consideration of individual patient characteristics, comorbidities (eg, concurrent psychiatric, pulmonary, renal, or hepatic illness), and concurrent medications, using flexible dosing protocols that take into account incomplete opioid cross-tolerance. References cited in this review were identified via a search of PubMed covering all English language publications up to May 21, 2013 pertaining to opioid rotation, excluding narrative reviews, letters, and expert opinion. The search yielded a total of 129 articles, 92 of which were judged to provide relevant information and subsequently included in this review. Through a review of this literature and from the authors' empiric experience, this review provides practical information on performing opioid rotation in clinical practice.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.