Dr. Eni Williams graduated from Creighton University in 1988 with a B.S. degree in pharmacy and a Doctor of Pharmacy from Howard University in 1994. She also obtained a Ph.D. in Public Policy in 2009 at the University of Maryland, Baltimore County.
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.
PREGNANCY AND BREASTFEEDING SAFETY: 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 breast feeding infant. The
benefit to the mother of taking methadone while breast feeding should be weighed
against the risks to the infant.
STORAGE: 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.
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 to 40 mg given every 6 to 12 hours.
The initial total daily
dose for detoxification usually is higher, and this can range from 20 to 120 mg
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 10 mg 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 CLASS AND MECHANISM: 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.