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© BMJ Publishing Group Limited 2020. No commercial re-use. See rights and permissions. Published by BMJ.CONTEXT Methadone is a useful option in the treatment of cancer pain. Despite its advantages, methadone use is complicated due to high interindividual variability in pharmacokinetics. Various rotation methods from other opioids have been proposed in mostly Caucasian populations. OBJECTIVES This study aims to describe our experience with opioid rotation to methadone for management of cancer pain in a predominantly Asian population. ME