methadone (Dolophine; Methadone HCl Intensol; Methadose; Methadose Sugar-Free)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jay W. Marks, MD
    Jay W. Marks, MD

    Jay W. Marks, MD

    Jay W. Marks, MD, is a board-certified internist and gastroenterologist. He graduated from Yale University School of Medicine and trained in internal medicine and gastroenterology at UCLA/Cedars-Sinai Medical Center in Los Angeles.

Prescription Drug Abuse Statistics

What is methadone-oral tablet, and how does it work (mechanism of action)?

Methadone is a strong, synthetic (man-made) narcotic that acts on the central nervous system (brain) in a manner similar to other narcotics. It is used in the management of narcotic addiction and for pain control. Methadone was first approved by the Food and Drug Administration on August 13 1947.

What brand names are available for methadone-oral tablet?

Dolophine; Methadone HCl Intensol; Methadose; Methadose Sugar-Free

Is methadone-oral tablet available as a generic drug?

Yes

Do I need a prescription for methadone-oral tablet?

Yes

What are the side effects of methadone-oral tablet?

Methadone is very addicting and causes significant sedation and respiratory depression. Methadone side effects include: 

These tend to happen during the first few days as the body adjusts to the medication.

Methadone also may cause:

Some of these side effects may go away with continued use.

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What is the dosage for methadone-oral tablet?

The initial dose of oral methadone in patients who require continuous pain control throughout the day can range from 2.5 to 10 mg given every 8 to 12 hours. Those who are seriously ill may need to be started at an oral dose of 10-40 mg given every 6-12 hours. The initial total daily dose for detoxification usually is higher, and this can range from 20 to 120 mg daily. The usual dose for methadone solution for injection when treating moderate to severe pain in patients who require continuous pain control is 2.5 to 10mg given as intravenous (I.V.), subcutaneous (SubQ) or intramuscular (I.M.) injection every 8-12 hours.

The conversion ratio from oral methadone to methadone given as an injection (I.V., SubQ) or I.M.) is 2:1. The total daily amount of methadone that a person is prescribed is not fixed, and it will depend on many factors including the severity of the pain, prior use of methadone, medications that are being taken concomitantly, the response to treatment and other factors that may be specific to a person. Therefore, each person has to be monitored carefully while receiving methadone. When stopping therapy, the dose of methadone should be gradually reduced in order to avoid withdrawal symptoms.

Which drugs or supplements interact with methadone-oral tablet?

Methadone when taken with drugs that slow brain function, such as alcohol and barbiturates (phenobarbital), can increase the effects of these drugs. Since methadone causes constipation, taking antidiarrheal medications such as diphenoxylate and atropine (Lomotil) and loperamide (Imodium) along with methadone can result in severe constipation. Drugs that block narcotic (opioid) receptors including pentazocine (Talwin), nalbuphine (Nubain), naloxone (Narcan), butorphanol (Stadol) and buprenorphine (Subutex) can lead to withdrawal symptoms.

Rifampin (Rifadin), barbiturates, carbamazepine (Tegretol), phenytoin (Dilantin), primidone and St. John's wort preparations can increase the liver's ability to metabolize (eliminate) methadone and reduce its blood concentration which could result in withdrawal side effects, while drugs such as erythromycin (E-Mycin, Eryc, Ery-Tab), clarithromycin (Biaxin, Biaxin XL), ketoconazole (Nizoral), and itraconazole (Sporanox) can decrease the liver's ability to metabolize methadone thereby increasing the side effects of this drug.

Anti-retroviral agents including abacavir (Ziagen), amprenavir (Agenerase), efavirenz (Sustiva), nelfinavir (Viracept), Nevirapine (Viramune, Viramune XR), Ritonavir (Norvir), and lopinavir/ ritonavir (Kaletra) have been shown to decreased the blood levels of methadone making it necessary to adjust the dose of methadone to prevent narcotic withdrawal effects.

Some drugs that slow the heart rate for example, dofetilide (Tikosyn), procainamide (Pronestyl, Procan-SR), quinidine, and sotalol ((Betapace), as well as laxatives and diuretics that cause low magnesium or low potassium in the body, for example, furosemide (Lasix), can cause rare serious and fatal irregular heartbeats.

Is methadone-oral tablet safe to take if I'm pregnant or breastfeeding?

Safety during pregnancy has not been established. Methadone has been shown to cross the placenta, and it is found in cord blood, amniotic fluid and in the newborn urine. Children born to mothers who were taking methadone for a prolonged period may exhibit respiratory depression or withdrawal symptoms.

Methadone enters breast milk, and this can cause sedation and respiratory depression in the breastfeeding infant. The benefit to the mother of taking methadone while breast feeding should be weighed against the risks to the infant.

What else should I know about methadone-oral tablet?

What preparations of methadone-oral tablet are available?

  • Oral concentrate: 10 mg/mL
  • Oral solution: 5 and 10 mg per teaspoon
  • Oral tablet: 5 mg and 10 mg
  • Soluble tablet, 40mg
  • Solution for Injection 5 and 10 mg per teaspoon: 10 mg/mL

How should I keep methadone-oral tablet stored?

Oral methadone and injection should be stored at room temperature between 15 C and 30 C (59 F and 86 F). Methadone injection also should be protected from light.

Medically reviewed by John P. Cunha, DO, FACOEP

REFERENCE:

FDA.gov Prescribing Information.

Last Editorial Review: 5/12/2017

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Reviewed on 5/12/2017
References
Medically reviewed by John P. Cunha, DO, FACOEP

REFERENCE:

FDA.gov Prescribing Information.

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