The use of sublingual methadone for breakthrough cancer pain could be an alternative where transmucosal fentanyl is not available. The incidence of breakthrough pain among cancer patients has been estimated at 40–80% depending on the setting. It`s typically rapid in onset, in 3 min or less, and short in duration, subsiding within 30 min. Finding faster and more effective treatments, and novel routes of drug administration for managing breakthrough pain, is critical.
We conduct a study with 19 patients using sublingual methadone to control pain crisis and it promoted great pain control for most patients in less than 10 min with one or at most two doses, with very low rate of side effect and excellent adhesion.

SUBLINGUAL METHADONE: A NEW ROUTE FOR AN OLDER DRUG IN CANCER PAIN ?