Description

methadone Hydrochloride

Generic name: methadone (oral/injection) [ METH-a-done ]
Brand names: Dolophine, Methadose, Methadose Sugar-Free, Diskets
Dosage forms: injectable solution, intravenous solution, oral concentrate, oral solution, oral tablet, oral tablet, dispersible.
Drug class: Opioids (narcotic analgesics)

What is methadone?

Methadone is a long-acting opioid medication that is used to reduce withdrawal symptoms in people addicted to heroin or other narcotic drugs, and it can also used as a pain reliever.  When methadone is used for Opioid Use Disorder (OUD) it reduces withdrawal symptoms and drug cravings, but does not cause the “high” associated with the drug addiction.

Methadone is highly regulated medication (Schedule 2 Controlled Substances Act) and when used for OUD is only available through approved opioid treatment programs (OTP) that involves regular monitoring, counseling, and drug testing to make sure that patients are making progress in their recovery.

It is a medication used for several purposes. It is a long-acting opioid medication. It can be used to relieve moderate to severe pain when continuous pain relief is needed for an extended period of time.

This is also commonly used in the treatment of opioid use disorder as it helps reduce withdrawal symptoms and cravings in individuals addicted to heroin or other narcotic drugs.

It is important to note that this medicine should only be used under the supervision of a healthcare professional, as it is a potent medication with potential side effects and risks

When methadone is used for pain it should only be used for pain that is severe enough to require daily, around-the-clock, long-term opioid treatment when no other treatment options have helped adequately. This medicine is not for use on an as-needed basis for pain.

Methadone works by activating the opioid receptors in the brain and nervous system, it is usually taken orally as a liquid or tablet.

Warnings

Methadone hydrochloride is a potent opioid medication primarily used for the treatment of opioid dependence and chronic pain management. While it can be effective when used under proper medical supervision, there are several important warnings and precautions to be aware of:

1. Addiction and Dependence: Methadone itself is an opioid and carries the risk of addiction and physical dependence. It should only be used as prescribed by a healthcare professional and closely monitored to minimize the potential for abuse.

2. Respiratory Depression: Methadone can cause respiratory depression, which is characterized by slowed or shallow breathing. This effect can be dangerous, especially if higher doses are taken or when combined with other central nervous system depressants like alcohol or benzodiazepines. Caution is advised, particularly for individuals with respiratory conditions.

3. Overdose Risk: Taking too much methadone or combining it with other opioids or depressant substances can lead to an overdose, which can be life-threatening. It is crucial to follow the prescribed dosage and avoid taking additional medications without consulting a healthcare provider.

4. QT Prolongation: Methadone has the potential to cause a heart rhythm disorder called QT prolongation. Individuals with a history of heart problems or who are taking medications known to prolong the QT interval should exercise caution and be closely monitored while on methadone.

5. Drug Interactions: Methadone can interact with other medications, including certain antidepressants, antifungal agents, and HIV medications. These interactions can increase the risk of adverse effects or reduce the effectiveness of either medication. It is important to inform your healthcare provider about all the medications you are taking to minimize these risks.

6. Withdrawal Syndrome in Newborns: Pregnant individuals on methadone maintenance treatment should be aware that the drug can cause withdrawal symptoms in newborns. This condition, known as neonatal abstinence syndrome, requires careful management and monitoring by healthcare professionals.

7. Side Effects: Methadone can cause side effects such as

• drowsiness,
• dizziness,
• constipation,
• nausea, and sweating.

These effects are generally temporary and should subside as the body adjusts to the medication. However, if these side effects persist or worsen, it is important to consult a healthcare provider.

Methadone side effects

Get emergency medical help if you have signs of an allergic reaction to methadone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should give naloxone and/or seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up.

Serious methadone side effects.

Call your doctor at once if you have:

• weak or shallow breathing, breathing that stops during sleep;
• severe constipation;
• a light-headed feeling, like you might pass out;
• fast or pounding heartbeats, fluttering in your chest, shortness of breath;
• low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness; or
• serotonin syndrome – agitation, hallucinations, fever, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, diarrhea.

Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders.

Common methadone side effects may include:

• dizziness, drowsiness;
• nausea, vomiting;
• increased sweating; or
• pain, redness, or swelling where the medicine was injected.

How should I use methadone Hydrochloride?

The use of methadone hydrochloride should always be directed and monitored by a qualified healthcare professional, typically a doctor experienced in addiction medicine or pain management. It is important to follow their instructions and the prescribed dosage carefully. Here are some general guidelines for using methadone hydrochloride:

1. Prescription and Dosage: Methadone is a prescription medication, and you should only use it as prescribed by your healthcare provider. The dosage will vary depending on the purpose of treatment, whether it’s for opioid dependence or chronic pain management. The initial dose and subsequent adjustments should be determined by your doctor based on your individual needs and response to the medication.

2. Administration: Methadone hydrochloride is typically available as an oral solution, concentrate, or tablet. Follow your doctor’s instructions on how to take it. If it is a liquid solution or concentrate, measure the dose using a special measuring device or syringe provided with the medication. Do not use household spoons, as they may not provide accurate measurements.

3. Timing and Frequency: Take methadone as prescribed by your healthcare provider. The dosing schedule and frequency may vary depending on your specific treatment plan. It is essential to follow the recommended timing and spacing between doses to maintain consistent blood levels of the medication.

4. Avoid Alcohol and Other Substances: Do not consume alcohol or use other substances that can interact with methadone, such as sedatives, tranquilizers, or illicit drugs. Combining methadone with these substances can lead to dangerous interactions and increase the risk of respiratory depression and other adverse effects.

5. Regular Monitoring: Your healthcare provider will monitor your progress and adjust the dosage as needed. You may need to visit the doctor regularly for check-ups, urine tests, and discussions about your treatment plan. Keep all scheduled appointments and communicate any concerns or changes in your condition to your healthcare provider.

6. Treatment Duration: The duration of methadone treatment can vary depending on the individual and the specific circumstances. For opioid dependence, it may be part of a comprehensive addiction treatment program, including counseling and behavioral therapies. For chronic pain management, the duration will depend on the underlying condition and the effectiveness of the treatment.

7. Discontinuation: If you and your healthcare provider decide to discontinue methadone treatment, it is important to do so under medical supervision. Abruptly stopping methadone can lead to withdrawal symptoms. Your doctor will develop a tapering plan to gradually reduce the dosage and minimize withdrawal effects.

Remember, these guidelines are general in nature, and individualized instructions from your healthcare provider should always take precedence. It is crucial to have open and honest communication with your doctor regarding your treatment plan, progress, and any concerns you may have during methadone hydrochloride use.

WHAT OTHER DRUGS INTERACT WITH METHADONE HYDROCHLORIDE?

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Severe Interactions of methadone include:
• alvimopan
• eliglustat
• itraconazole
• ketoconazole
• rasagiline
• selegiline

Methadone has serious interactions with at least 59 different drugs.
Methadone has moderate interactions with at least 315 different drugs.
Mild Interactions of methadone include:

• azithromycin
• brimonidine
• dextroamphetamine
• eucalyptus
• lidocaine
• naloxone
• octreotide
• octreotide (antidote)
• pazopanib
• ruxolitinib
• sage
• ziconotide
• zidovudine

Before taking this medicine

You should not use this medicine if you are allergic to it, or if you have:

• severe asthma or breathing problems; or
• a blockage in your stomach or intestines.

This medicine may cause a life-threatening heart rhythm disorder. Your heart function may need to be checked during treatment.

To make sure methadone is safe for you, tell your doctor if you have ever had:

• heart problems, long QT syndrome (in you or a family member);
• breathing problems, sleep apnea;
• a head injury, brain tumor, or seizures;
• drug or alcohol addiction, or mental illness;
• liver or kidney disease;
• urination problems; or
• problems with your gallbladder, pancreas, or thyroid.

Pregnancy

Talk to your doctor before using opioid medicine if you are pregnant or planning a pregnancy. If you use opioid medicine during pregnancy, your baby could be born with life-threatening withdrawal symptoms, called neonatal opioid withdrawal syndrome (NOWS) which is treatable and your baby may need medical treatment for several weeks.

Breastfeeding

Ask a doctor before using opioid medicine if you are breastfeeding. This medicine passes into breast milk and may harm your baby.  Tell your doctor immediately if you notice increased sleepiness (more than usual), difficulty breastfeeding, breathing difficulties, or limpness in the nursing baby. Talk to your baby’s doctor when you decide to wean your baby. It is important to wean your baby gradually so that your baby does not develop withdrawal symptoms when he or she stops receiving methadone in breastmilk.