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June 16, 1956


JAMA. 1956;161(7):599-603. doi:10.1001/jama.1956.02970070031008

• The analgesic effect of racemic alpha acetylmethadol was studied in 49 patients suffering chronic pain due to cancer, 10 recovering after surgery, and 17 in chronic or transient pain from other causes. Doses of 5 to 10 mg. given three or four times daily were highly effective on continued use.

Good relief from pain was obtained by either oral administration or subcutaneous injection. A few patients complained of lethargy. Hypnotics were usually needed for sleep. It was possible in several patients to discontinue use of frequent injections of large doses of morphine or meperidine and to change over completely to the oral use of acetylmethadol without causing withdrawal symptoms.

Constipation was bothersome with large daily doses (30 to 50 mg.). Other side-effects were infrequent. The toxic effects of cumulation with large doses can be avoided by taking into account the patient's metabolic and excretory status. In the majority of patients in this series, the oral administration of acetylmethadol has afforded relief from chronic pain for several months without severe untoward effects.