Methadone
Intractable Pain, Opioid-Related Disorders
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Drug Status
Government Approvals
US(FDA), UK(BNF)
WHO Essential Medicine
YES
Known Teratogen
No
Pharmaceutical Class
Opioid Agonist
Controlled Drug Substance
YES
Methadone
Summary
Methadone is used to manage severe pain that requires long-term, around-the-clock opioid treatment. It is also used for detoxification and maintenance treatment of opioid addiction, such as heroin or other morphine-like drugs.
Methadone works by binding to opioid receptors in the brain, altering the perception of pain and reducing withdrawal symptoms. It also acts as an NMDA receptor antagonist, which may contribute to its effectiveness in treating chronic pain and opioid addiction.
For adults, the usual daily dose of Methadone for pain management starts at 2.5 mg every 8 to 12 hours, adjusted based on response. For opioid addiction, initial doses are typically 20-30 mg, not exceeding 40 mg on the first day. Methadone is not recommended for children.
Common side effects of Methadone include drowsiness, dizziness, nausea, and constipation. Serious adverse effects can include respiratory depression and QT prolongation.
Key warnings for Methadone include the risk of addiction, respiratory depression, and interactions with other CNS depressants. Contraindications include severe asthma, gastrointestinal obstruction, and hypersensitivity to Methadone. Patients should be monitored closely, especially during dose changes.
Indications and Purpose
How does Methadone work?
Methadone works by binding to opioid receptors in the brain, altering the perception of pain and producing effects similar to other opioids. It helps reduce withdrawal symptoms and cravings in people with opioid addiction.
Is Methadone effective?
Methadone is effective in managing severe pain and treating opioid addiction by reducing withdrawal symptoms and cravings. It works by altering the way the brain and nervous system respond to pain and by producing similar effects to opiates, preventing withdrawal symptoms.
What is Methadone?
Methadone is used to manage severe pain and treat opioid addiction by reducing withdrawal symptoms and cravings. It works by changing how the brain and nervous system respond to pain and by producing effects similar to opiates, preventing withdrawal symptoms.
Directions for Use
For how long do I take Methadone?
Methadone is used for long-term treatment, especially in managing opioid addiction or chronic pain. The duration varies based on individual needs and should be determined by a healthcare provider.
How do I dispose of Methadone?
If you can, bring unused medicines to a drug take-back program or collection site at a pharmacy or hospital. They will dispose of this medicine properly so they don't harm people or the environment. If you can't find a take-back program, you can throw most medicines in the trash at home. But first, take them out of their original containers, mix them with something undesirable like used coffee grounds, seal the mixture in a plastic bag and throw it away.
How do I take Methadone?
Methadone can be taken with or without food. However, it is important to follow the healthcare provider's instructions regarding dosage and timing. There are no specific food restrictions, but alcohol should be avoided due to the risk of serious side effects.
How long does it take for Methadone to start working?
Methadone typically begins to work within 30 minutes to an hour after oral administration. The full effects may take longer to be felt, depending on the individual's metabolism and the dosage.
How should I store Methadone?
Methadone should be stored in a tightly closed container at room temperature, away from excess heat and moisture. It should be kept out of reach of children and in a secure location to prevent accidental ingestion or misuse.
What is the usual dose of Methadone?
For adults, the usual daily dose of Methadone for maintenance treatment is typically between 40 to 60 mg. Methadone is not recommended for use in children due to the risk of serious side effects and overdose.
Warnings and Precautions
Can I take Methadone with other prescription drugs?
Methadone can interact with benzodiazepines, other CNS depressants, and drugs affecting cytochrome P450 enzymes, increasing the risk of respiratory depression and sedation. It is important to inform healthcare providers of all medications being taken to avoid harmful interactions.
Can Methadone be taken safely while breastfeeding?
Methadone passes into breast milk and may affect the baby. Breastfeeding mothers should monitor their infants for increased sleepiness or breathing difficulties and consult a healthcare provider for guidance on safe use during breastfeeding.
Can Methadone be taken safely while pregnant?
Methadone use during pregnancy can lead to neonatal opioid withdrawal syndrome, which is treatable but may be life-threatening if not managed. Pregnant women should consult their healthcare provider to weigh the benefits and risks and to ensure proper monitoring.
Does Methadone have adverse effects?
Adverse effects are unwanted or harmful effects caused by a medication. Methadone can cause several adverse effects. Common ones include drowsiness, constipation, and nausea. Serious adverse effects, though rare, may include difficulty breathing, chest pain, or severe allergic reactions. If you experience any of these serious symptoms, seek medical attention immediately. It's important to report any new or worsening symptoms to your healthcare provider. Never stop taking Methadone without consulting your doctor, as they can help manage side effects and adjust your treatment if necessary.
Does Methadone have any safety warnings?
Methadone comes with several safety warnings. It can cause serious breathing problems, especially during the first 24 to 72 hours of treatment. Watch for signs like slow or shallow breathing. Methadone can also affect heart rhythm, leading to a condition called QT prolongation, which can cause irregular heartbeats. Symptoms to watch for include dizziness or fainting. Methadone may also cause drowsiness, increasing the risk of accidents. Avoid driving or operating heavy machinery until you know how it affects you. Always follow your healthcare provider's instructions and report any unusual symptoms immediately.
Is it safe to drink alcohol while taking Methadone?
Drinking alcohol while taking Methadone can increase the risk of serious side effects, including life-threatening breathing problems, sedation, or coma. It is advised to avoid alcohol during Methadone treatment.
Is it safe to exercise while taking Methadone?
Methadone may cause dizziness or drowsiness, which can affect physical coordination and exercise performance. It is important to assess how Methadone affects you personally and consult a healthcare provider before engaging in strenuous activities.
Is it safe to stop Methadone?
Methadone is often used for long-term management of chronic pain or opioid dependence. Stopping Methadone suddenly can lead to withdrawal symptoms, which may include anxiety, nausea, sweating, and muscle aches. In some cases, abrupt discontinuation can be life-threatening, especially if Methadone is used for opioid dependence. It's crucial to consult with a healthcare provider before stopping Methadone. They can guide you on how to taper off the medication safely to minimize withdrawal symptoms and avoid complications. Never stop taking Methadone without medical advice.
Is Methadone addictive?
Methadone does have habit-forming potential. It can lead to physical dependence because it affects the brain's opioid receptors, which are involved in pain and pleasure. Warning signs of dependence include needing higher doses to achieve the same effect, cravings, and withdrawal symptoms when not taking it. To prevent addiction, follow your healthcare provider's instructions carefully, do not adjust your dose without consulting them, and attend regular check-ups. If you notice any signs of dependence, talk to your doctor immediately. They can help manage your treatment and reduce the risk of addiction.
Is Methadone safe for the elderly?
Elderly patients may be more sensitive to Methadone's effects, particularly respiratory depression and sedation. It is important to start with a lower dose and monitor closely for side effects. Regular consultations with a healthcare provider are recommended to ensure safe use.
What are the most common side effects of Methadone?
A side effect is an unwanted reaction to a medication. Common side effects of Methadone include drowsiness, constipation, nausea, dizziness, and sweating. These effects are often mild and may decrease as your body adjusts to the medication. It's important to note that new symptoms can occur when starting any new medicine, and they may not always be related to the medication. Always talk to your healthcare provider before stopping Methadone, as they can help manage side effects and ensure your treatment is safe and effective.
Who should avoid taking Methadone?
Methadone can cause life-threatening breathing problems, especially when starting treatment or increasing the dose. It should not be used with alcohol or other CNS depressants. People with respiratory issues, heart problems, or a history of substance abuse should use it cautiously.
