methadone (Dolophine; Methadone HCl Intensol; Methadose; Methadose Sugar-Free) (cont.)
Omudhome Ogbru, PharmD
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:
DOSING: 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.
DRUG INTERACTIONS: 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.
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