Introduction: - Pain is one of the most prevalent cancer symptoms. There is individual variability in analgesia and adverse effects to different opioids. So, we did this study to provide the comparative information about Morphine and Methadone for intractable pain control and their potential for adverse effects in advanced cancer patients.

Aims and Objectives: - To evaluate analgesic effect and safety of Morphine and Methadone for management of chronic sever pain. To identify adverse effects of study drugs

Method: - Total 50 patients were enrolled randomly and divided randomly in Morphine group and Methadone group of 25 patients in each. Patients were selected according to inclusion and exclusion criteria. Group 1: - received oral Morphine. Group 2: - received oral Methadone. We assessed pain control by monitoring VAS and escalated dose of opioids as required for adequate pain control, observed side effects and treated, did ECG to see QTc changes on follow-up.

Result: - As for adequate pain relief, we increased dose in both group of patients according to patients’ severity of pain. There was less average dose of methadone is required in terms of Morphine Milligram Equivalent (MME) than average dose of morphine. We find different side effects with different frequency and treated with rescue medication.

Conclusion: - Morphine and Methadone both are very effective in management of severe pain in advance cancer patients. We didn’t observe any major side effect. So, one should not hesitate to start either of them in advance cancer patients to treat pain.