Opioid-sparing effect of diclofenac in cancer pain

Sebastiano Mercadante, Monica Sapio, Marina Caligara, Roberto Serretta, Gabriella Dardanoni, Luca Barresi

Research output: Contribution to journalArticlepeer-review


This study investigated the opioid-sparing effect of diclofenac using patient-controlled analgesia with oral methadone. Fifteen patients with advanced cancer participated. After achieving adequate analgesia with regular dosing of oral methadone (T1), patient-controlled analgesia with methadone was administered for 3 days (T2). Intramuscular diclofenac 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 significantly reduced at T3. A reduction in methadone plasma concentration was also observed at T2 and T3, although it did not attain statistical significance. Significant decreases in the intensity of several symptoms 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.

Original languageEnglish
Pages (from-to)15-20
Number of pages6
JournalJournal of Pain and Symptom Management
Issue number1
Publication statusPublished - Jul 1997


  • Cancer pain
  • Diclofenac
  • Methadone
  • NSAIDs
  • Opioids
  • Patient-controlled analgesia

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology
  • Neurology
  • Nursing(all)

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