Methadone

Please note: these are basic guidelines, refer to your doctor for a professional medical opinion.

Popular brand names:

Physeptone, Equity-Methadone

Drug group:

Opioid analgesic

Prescription needed?

Yes

What does it do?

Methadone can be used to:

• Prevent withdrawal symptoms in the treatment of morphine/heroin dependence
• Relieve severe pain
• To suppress a cough in terminal illness

How does it work?

Methadone is a synthetic drug belonging to the opioid analgesic group.

How should it be used?

Use the lowest possible dose of methadone for the shortest duration – high risk of developing a tolerance to, and becoming dependent on the drug

What is the typical dosage?

Your doctor will recommend a dosage tailored to your need, but typically:

• Opioid addiction: 10–20mg once daily (starting dose); increasing to 40–60mg daily (maintenance dose); dose can sometimes be reduced until the drug is no longer needed
• Pain: initially 5–10mg per dose, adjusted according to response, given 3–4 x daily (2 x daily for prolonged use)
• Cough: 1–2mg per dose, initially 4–6 x daily (2 x daily for prolonged use)

How quickly will it start to work?

15–60 minutes                       
           

How long will the effects last?

36–48 hours                    
        

When should I stop using it?

Can be slowly reduced and safely stopped when no longer needed, discuss with your doctor.

Is it safe for prolonged use?

High risk of dependence with long-term use of methadone, treatment is always closely monitored. To avoid withdrawl symptoms the dose must be carefully reduced before the drug is stopped.

What are the possible side effects?

The following have been reported:

• More common: nausea, vomiting, drowsiness (these diminish as your body adapts to the drug), constipation (may be longer lasting), dizziness, confusion
• Report to your doctor before taking your next dose if you experience: loss of consciousness, slow/difficult breathing

OVERDOSE ACTION

Dangerous in overdose - seek urgent medical care in all cases.

NOTE: The effective dose for someone dependent on methadone could be fatal for a person who has not used opioids.

What other considerations are important?

Dosage may be adjusted by your doctor under certain conditions.

• Certain health problems: heart/circulatory problems, liver/kidney problems, lung problems (such as asthma/bronchitis), thyroid disease, history of epilepsy/seizures, phaeochromocytoma (adrenal gland tumour), problems with alcohol abuse
• Other medicines: phenytoin, carbamazepine, rifampicin, monoamine oxidase inhibitors (MAOIs), selegiline, erythromycin/clarithromycin, fluconazole, cimetidine, ritonavir, sedatives
• Pregnancy and breast-feeding: Not prescribed in pregnancy - may cause breathing difficulties in the newborn baby, safety not established in breast-feeding
• Children: Not recommended
• Over 60: Reduced dose necessary
• Driving and hazardous work: Your underlying condition and the side effects of the drug may make such activities dangerous
• Alcohol: Avoid, enhanced sedative effects