Observational studyJournal of pain and symptom management2016
Methadone Use and the Risk of Hypoglycemia for Inpatients With Cancer Pain.
Observational study in Journal of pain and symptom management, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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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.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 32 citations in OpenAlex.
- Subcutaneous or intravenous opioid administration by patient-controlled analgesia in cancer pain: a systematic literature review.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2019Pooled it
- Exploratory associations between co-occurring opioid and alcohol use disorders and GIP/GLP-1 receptor agonist treatment.Communications medicine · 2026Article
- Opioid-Induced Hypoglycemia in Diabetes: Dose-Dependent Effects of Methadone in a Complex Chronic Pain Patient.Cureus · 2025Article
- Article
- Methadone-Induced Hypoglycemia in a Hospitalized Patient.Hospital pharmacy · 2024Article
- Methadone-induced hypoglycemia: A case report.Journal of diabetes investigation · 2023Article
- Insulinoma mimic: methadone-induced hypoglycaemia.BMJ case reports · 2022Article
- The Effect of Different Opioids on Acid-Base Balance and Blood Gas Analysis in Hospitalized Dogs.Frontiers in veterinary science · 2022Article
- The effect of methadone on blood glucose, lipids and glucose-modulating hormones in methadone-dependent Wistar rats.Toxicological research · 2020Article
- Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone.Scientific reports · 2020Article
- Retrospective analysis reveals significant association of hypoglycemia with tramadol and methadone in contrast to other opioids.Scientific reports · 2019Article
- Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity.Journal of medical toxicology : official journal of the American College of Medical Toxicology · 2018Review
- A case report of methadone-associated hypoglycemia in an 11-month-old male.Clinical toxicology (Philadelphia, Pa.) · 2018Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
contextMethadone is an important drug in the management of both cancer-related and non-cancer-related pain and is the main pharmacologic agent used in the treatment of opioid addiction. Unexpected hypoglycemia has been observed in patients receiving methadone, prompting a more detailed investigation.
objectivesTo evaluate the incidence of hypoglycemia in a cohort of inpatients receiving methadone versus other opioids including fentanyl, hydromorphone, and morphine.
methodsRetrospective observational cohort of inpatients in a tertiary cancer center admitted for more than 48 hours from November 1, 2011 to October 30, 2013. The main outcomes were lowest measured daily blood glucose (in mg/dL) and incidence of hypoglycemia (defined as blood glucose < 70 mg/dL, equivalent to 3.9 mmol/L) with variable methadone doses compared with other non-methadone opioids.
resultsOf the 641 eligible patients admitted during the study period who received at least one dose of methadone during admission, multivariable logistic regression showed significant associations between methadone and hypoglycemia at doses greater than 40 mg oral equivalents per day or with patient-controlled analgesia use. A dose-response relationship was observed, with an odds ratio of 3.1 (95% confidence interval 2.5, 3.6) when doses greater than 80 mg/day were used. No evidence of increased risk of hypoglycemia or of a dose-response curve was seen for the other opioids.
conclusionThe risk of hypoglycemia is increased for patients taking more than 40 mg oral methadone equivalents per day. When starting methadone at or more than 40 mg/day, we recommend blood glucose monitoring.
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