Methadone (Dolophine; Methadone HCl; Methadose) Side Effects

What are oral methadone tablets, and what are they used for?

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 tablet?

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

Is methadone tablet available as a generic drug?

Yes

Do I need a prescription for methadone tablet?

Yes

What are the side effects of methadone 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.

What is the dosage for methadone 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 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.

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Is methadone 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 tablet?

What preparations of methadone 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 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.

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