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Methadone

Brand Name(s): | IMPORTANT WARNING | WHY is this medicine prescribed? | HOW should this medicine be used? | Are there OTHER USES for this medicine? | What SPECIAL DIETARY instructions should I follow? | What should I do IF I FORGET to take a dose? | What SIDE EFFECTS can this medicine cause? | What should I know about STORAGE and DISPOSAL of this medication? | What should I do in case of OVERDOSE? | What OTHER INFORMATION should I know? |

Brand Name(s):

  • Dolophine®
  • Methadose®
  • Methadose®Oral Concentrate
  • Westadone®¶

IMPORTANT WARNING

Methadone may cause slowed breathing and irregular heartbeat, which may be life-threatening. If you experience any of the following symptoms, call your doctor immediately: difficulty breathing; extreme drowsiness; slow, shallow breathing; fast, slow, pounding, or irregular heartbeat; faintness; severe dizziness; or confusion.

The risk that you will experience serious or life-threatening side effects of methadone is greatest when you first start taking methadone, when you switch from another narcotic medication to methadone and when your doctor increases your dose of methadone. Your doctor may start you on a low dose of methadone and gradually increase your dose. Your doctor will monitor you closely during this time.

Follow the directions on your prescription label carefully and ask your doctor or pharmacist to explain any part you do not understand. Take methadone exactly as directed. Do not take more methadone or take methadone more often than prescribed by your doctor. If you are taking methadone to control pain, your pain may return before it is time for your next dose of methadone. If this happens, do not take an extra dose of methadone. You will still have methadone in your body after the pain relieving effect of the medication wears off. If you take extra doses, you may have too much methadone in your body and you may experience life-threatening side effects. Be aware that the pain relieving effects of methadone will last longer as your treatment continues for a longer time. Talk to your doctor if your pain is not controlled during your treatment with methadone.

Talk to your doctor about the risks of taking methadone for your condition.

Use of methadone to treat opiate addiction:

If you have been addicted to an opiate (narcotic drug such as heroin), and you are taking methadone to help you stop taking or continue not taking the drug, you must enroll in a treatment program. The treatment program must be approved by the state and federal governments and must treat patients according to specific federal laws. You may have to take your medication at the treatment program facility under the supervision of the program staff. Ask your doctor or the treatment program staff if you have any questions about enrolling in the program or taking or getting your medication.

WHY is this medicine prescribed?

Methadone is used to relieve moderate to severe pain that has not been relieved by non-narcotic pain relievers. It also is used to prevent withdrawal symptoms in patients who were addicted to opiate drugs and are enrolled in treatment programs in order to stop taking or continue not taking the drugs. Methadone is in a class of medications called opiate (narcotic) analgesics. Methadone works to treat pain by changing the way the brain and nervous system respond to pain. It also works as a substitute for opiate drugs of abuse by producing similar effects and preventing withdrawal symptoms in people who have stopped using these drugs.

HOW should this medicine be used?

Methadone comes as a tablet, a dispersible tablet (can be dissolved in liquid), a solution (liquid), and a concentrated solution (liquid that must be diluted before use) to take by mouth. When methadone is used to relieve pain, it may be taken every 4 to 12 hours. If you take methadone as part of a treatment program, your doctor will prescribe the dosing schedule that is best for you.

Your doctor may change your dose of methadone during your treatment. Your doctor may decrease your dose or tell you to take methadone less often as your treatment continues. Ask your doctor or pharmacist if you have any questions about how much methadone you should take or how often you should take the medication.

Methadone can be habit-forming. Call your doctor if you find that you want to take extra medication or notice any other unusual changes in your behavior or mood.

Do not stop taking methadone without talking to your doctor. Your doctor will probably want to decrease your dose gradually. If you suddenly stop taking methadone, you may experience withdrawal symptoms such as restlessness, teary eyes, runny nose, yawning, sweating, chills, muscle pain, and widened pupils (black circles in the middle of the eyes).

If you are using the dispersible tablets, place one tablet in a liquid such as water or citrus fruit juice. Wait 1 minute to allow the tablet to dissolve and then drink the entire mixture.

If you are using methadone oral concentrate solution, you should mix your prescribed dose of medication in at least 1 ounce (30 milliliters) of liquid such as water, citrus fruit juice, Kool Aid®, Tang®, apple juice, or Crystal Light®.

Are there OTHER USES for this medicine?

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What SPECIAL PRECAUTIONS should I follow?

Before taking methadone,

  • tell your doctor and pharmacist if you are allergic to methadone or any other medications.
  • tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); certain antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend); antihistamines; buprenorphine (Subutex); butorphanol (Stadol NS); calcium channel blocking agents such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Covera, Isoptin, Verelan); diuretics ('water pills'); erythromycin (E.E.S., E-Mycin, Erythrocin); laxatives; medications for anxiety, mental illness, nausea, or pain; medications for HIV including abacavir (Ziagen), amprenavir (Agenerase), didanosine (Videx), efavirenz (Sustiva), lopinavir (in Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, in Kaletra), stavudine (Zerit), and zidovudine (Retrovir); certain medications for irregular heartbeat such as disopyramide (Norpace), flecainide (Tambocor), mexiletine (Mexitil), moricizine (Ethmozine), procainamide (Procanbid, Pronestyl), propafenone (Rythmol), propranolol (Inderal), quinidine (Quinidex), and tocainide (Tonocard); certain medications for seizures such as carbamazepine (Carbatrol, Epitol, Tegretol), phenytoin (Dilantin, Phenytek); phenobarbital nalbuphine (Nubain); naloxone (Narcan);naltrexone (ReVia, Depade); pentazocine (Talwin); rifampin (Rifadin, Rimactane, in Rifamate); risperidone (Risperdal); sedatives; certain selective serotonin reuptake inhibitors (SSRIs) such as fluvoxamine (Luvox) and sertraline (Zoloft); sleeping pills; certain steroids such as cortisone, fludrocortisone (Flurinef), and hydrocortisone (Cortef); and tranquilizers. Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them in the past 14 days: monoamine oxidase (MAO) inhibitors including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelpar), and tranylcypromine (Parnate). Many other medications may also interact with methadone, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
  • tell your doctor what herbal products you are taking, especially St. John's wort.
  • tell your doctor if you have or have ever had asthma or other breathing problems or a blockage in your intestine. Your doctor may tell you that you should not take methadone.
  • tell your doctor if you have or have ever had a head injury, a brain tumor, a stroke, or any other condition that caused high pressure inside your skull; irregular heartbeat; urethral stricture (narrowing of the tube that carries urine out of the body), enlarged prostate (a male reproductive gland), or any other condition that causes difficulty urinating; Addison's disease (a condition in which the body does not make enough of certain natural substances); mental illness; chronic obstructive pulmonary disease (COPD; a group of lung diseases); kyphoscoliosis (condition in which the spine curves abnormally); sleep apnea (condition in which breathing stops for short periods during sleep); low levels of potassium or magnesium in your blood; or thyroid , heart, liver, or kidney disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol or if you use or have ever used street drugs or have overused prescription medications.
  • tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking methadone, call your doctor.
  • if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methadone.
  • you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
  • remember that alcohol can add to the drowsiness caused by this medication.
  • tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
  • you should know that methadone may cause dizziness when you get up too quickly from a lying position. This is more common when you first start taking methadone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

What SPECIAL DIETARY instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do IF I FORGET to take a dose?

If your doctor has told you to take methadone regularly, take the missed dose as soon as you remember it. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.

What SIDE EFFECTS can this medicine cause?

Methadone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:
  • drowsiness
  • weakness
  • headache
  • nausea
  • vomiting
  • constipation
  • loss of appetite
  • weight gain
  • stomach pain
  • dry mouth
  • sweating
  • flushing
  • difficulty urinating
  • swelling of the hands, arms, feet, and legs
  • mood changes
  • vision problems
  • difficulty falling asleep or staying asleep
  • decreased sexual desire or ability
  • missed menstrual periods
Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately:
  • seizures
  • itching
  • hives
  • rash

Methadone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

What should I know about STORAGE and DISPOSAL of this medication?

Keep this medication in the container it came in, tightly closed, and out of reach of children. Store it at room temperature and away from excess heat and moisture (not in the bathroom). Throw away any medication that is outdated or no longer needed. Talk to your pharmacist about the proper disposal of your medication.

Store methadone in a safe place so that no one else can take it accidentally or on purpose. Keep track of how many tablets or how much solution or concentrated solution is left so you will know if any is missing.

What should I do in case of OVERDOSE?

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:
  • small, pinpoint pupils (black circles in the center of the eyes)
  • slow or shallow breathing
  • drowsiness
  • cool, clammy, or blue skin
  • loss of consciousness; coma
  • limp muscles

What OTHER INFORMATION should I know?

Keep all appointments with your doctor, laboratory, and clinic. Your doctor will want to check your response to methadone.

This prescription is not refillable. If you continue to experience pain after you finish methadone, call your doctor. If you take this medication on a regular basis, be sure to schedule appointments with your doctor so that you do not run out of medication.

It is important for you to keep a written list of all of the prescription and nonprescription (over-the-counter) medicines you are taking, as well as any products such as vitamins, minerals, or other dietary supplements. You should bring this list with you each time you visit a doctor or if you are admitted to a hospital. It is also important information to carry with you in case of emergencies.

¶This branded product is no longer on the market. Generic alternatives may be available.

AHFS® Consumer Medication Information. © Copyright, The American Society of Health-System Pharmacists, Inc., 7272 Wisconsin Avenue, Bethesda, Maryland. All Rights Reserved. Duplication for commercial use must be authorized by ASHP.

Last Reviewed: February 1, 2009.

 

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