Methadone

Pronunciation: METH-a-done
Generic Name: Methadone
Brand Name: Examples include Dolophine and Methadose

Methadone may cause severe and sometimes fatal heart and breathing problems. These problems may occur some time after you take a dose. Tell your doctor right away if you develop any new or worsening symptoms such as slowed or shallow breathing or irregular heartbeat. Your doctor will perform heart and lung function tests to check for side effects while you take Methadone. Keep all doctor and laboratory appointments. Talk with your doctor and be sure you understand the risks and benefits of using Methadone.

Do not take more than the recommended dose or take Methadone more often than prescribed. This can lead to overdose and possible death.

Methadone is used for:

Treating moderate to severe pain that is not relieved by other pain medicines. It is also used in treating narcotic addiction as part of a treatment program. It may also be used for other conditions as determined by your doctor.

Methadone is a narcotic analgesic. It works by acting on opiate pain receptors in the brain and on smooth muscle to provide pain relief.

Do NOT use Methadone if:

• you are allergic to any ingredient in Methadone


• you have slowed breathing or severe asthma, or if you are having an asthma attack


• you have a stomach or bowel blockage or certain severe bowel problems (eg, paralytic ileus)


• you have diarrhea caused by food poisoning or antibiotic use


• you are taking sodium oxybate (GHB)


• if you have taken a monamine oxidase inhibitor type B (MAOI-B) (eg, rasagiline, selegiline) within the last 14 days

Contact your doctor or health care provider right away if any of these apply to you.

Before using Methadone:

Some medical conditions may interact with Methadone. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

• if you are pregnant, planning to become pregnant, or are breast-feeding


• if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement


• if you have allergies to medicines, foods, or other substances


• if you have lung or breathing problems (eg, asthma), chronic obstructive pulmonary disease (COPD), sleep apnea, stomach or bowel problems (eg, bowel inflammation), stomach pain or constipation, liver or kidney problems, thyroid problems, or Addison disease


• if you have an abnormal curvature of the spine; narrowing of the urethra, trouble urinating, or an enlarged prostate ; low blood volume, blood pressure, or blood oxygen levels; low potassium or magnesium blood levels; increased pressure, tumors, or lesions in your head; a recent head injury; or seizures


• if you have a history of heart problems (eg, enlarged heart) or irregular heartbeat


• if you or a family member have a history of mental or mood problems (eg, anxiety, depression), suicidal thoughts or attempts, or alcohol or substance abuse


• if you are elderly, very ill, or very overweight, or if you have recently had stomach or intestine surgery

Some MEDICINES MAY INTERACT with Methadone. Tell your health care provider if you are taking any other medicines, especially any of the following:

• Barbiturate anesthetics (eg, thiopental), benzodiazepines (eg, midazolam), cimetidine, MAOI-B (eg, rasagiline, selegiline), other narcotic analgesics (eg, morphine), phenothiazines (eg, promethazine), or sodium oxybate (GHB) because side effects such as sedation and slowed breathing may occur


• Antiarrhythmics (eg, amiodarone, dofetilide, flecainide, propafenone), antipsychotics (eg, haloperidol, paliperidone, ziprasidone), calcium channel blockers (eg, nifedipine), certain antiemetics (eg, dolasetron, droperidol), chloroquine, cisapride, diuretics (eg, furosemide), H₁ antagonists (eg, astemizole), kinase inhibitors (eg, lapatinib, nilotinib), lithium, macrolide antibiotics (eg, clarithromycin), phenothiazines (eg, chlorpromazine), quinolones (eg, ciprofloxacin), streptogramins (eg, quinupristin), tacrolimus, or tricyclic antidepressants (eg, desipramine) because the risk of QT prolongation may be increased


• Azole antifungals (eg, fluconazole, ketoconazole, voriconazole) or certain selective serotonin reuptake inhibitors (SSRIs) (eg, fluvoxamine, sertraline) because they may increase the risk of Methadone's side effects


• Abacavir, carbamazepine, efavirenz, HIV protease inhibitors (eg, amprenavir, lopinavir, nelfinavir, ritonavir), narcotic agonists/antagonists (eg, butorphanol, nalbuphine, pentazocine), narcotic antagonists (eg, naloxone, naltrexone), nevirapine, phenobarbital, phenytoin, rifampin, or St. John's wort because they may decrease Methadone's effectiveness


• Zidovudine because the risk of its side effects may be increased by Methadone


• Nucleoside reverse transcriptase inhibitors (NRTIs) (eg, abacavir, didanosine, stavudine) because their effectiveness may be decreased by Methadone

This may not be a complete list of all interactions that may occur. Ask your health care provider if Methadone may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

How to use Methadone:

Use Methadone as directed by your doctor. Check the label on the medicine for exact dosing instructions.

• An extra patient leaflet is available with Methadone. Talk to your pharmacist if you have questions about this information.


• Take Methadone by mouth with or without food. Methadone is for oral use only and must not be injected.


• Methadone must be administered under close medical supervision.


• Take Methadone on a regular schedule to get the most benefit from it. It is more effective in preventing pain than in treating pain after it occurs.


• If Methadone is no longer needed, dispose of it as soon as possible. Ask your doctor or pharmacist how to dispose of Methadone properly.


• Always keep Methadone in a secure place to protect from theft.


• If you miss a dose of Methadone, take it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not take 2 doses at once. If you miss your doses of Methadone for more than 2 days, contact your doctor before you start taking Methadone again.

Ask your health care provider any questions you may have about how to use Methadone.

Important safety information:

• Methadone may cause drowsiness, dizziness, blurred vision, or lightheadedness. These effects may be worse if you take it with alcohol or certain medicines. Use Methadone with caution. Do not drive or perform other possibly unsafe tasks until you know how you react to it.


• Do not drink alcohol or use medicines that may cause drowsiness (eg, sleep aids, muscle relaxers) while you are using Methadone; it may add to their effects. Ask your pharmacist if you have questions about which medicines may cause drowsiness.


• Methadone may cause dizziness, lightheadedness, or fainting; alcohol, hot weather, exercise, or fever may increase these effects. To prevent them, sit up or stand slowly, especially in the morning. Sit or lie down at the first sign of any of these effects.


• Breathing problems may occur some time after you take a dose of Methadone. Tell your doctor or seek medical care immediately if you notice trouble breathing (eg, slowed or shallow breathing) while you take Methadone


• Methadone may cause constipation. Constipation may be avoided by using a stool softener or fiber laxative.


• The risk of Methadone becoming habit-forming may be greater if you take it in high doses or for a long time. Do NOT take more than the recommended dose or use Methadone for longer than prescribed without talking with your doctor.


• Tell your doctor or dentist that you take Methadone before you receive any medical or dental care, emergency care, or surgery.


• Lab tests, including liver function, lung function, and heart function, may be performed while you use Methadone. These tests may be used to monitor your condition or check for side effects. Be sure to keep all doctor and lab appointments.


• Use Methadone with caution in the ELDERLY; they may be more sensitive to its effects.


• Methadone should not be used in CHILDREN; safety and effectiveness in children have not been confirmed.


• PREGNANCY and BREAST-FEEDING: Methadone may cause harm to the fetus. If you become pregnant, contact your doctor. You will need to discuss the benefits and risks of using Methadone while you are pregnant. Methadone is found in breast milk. If you are or will be breast-feeding while you use Methadone, check with your doctor. Discuss any possible risks to your baby.

When used for long periods of time or at high doses, Methadone may not work as well and may require higher doses to obtain the same effect as when originally taken. This is known as TOLERANCE. Talk with your doctor if Methadone stops working well. Do not take more than prescribed.

Some people who use Methadone for a long time may develop a need to continue taking it. People who take high doses are also at risk. This is known as DEPENDENCE or addiction.

If you suddenly stop taking Methadone, you may experience WITHDRAWAL symptoms including anxiety; diarrhea; fever, runny nose, or sneezing; goose bumps and abnormal skin sensations; nausea; vomiting; pain; rigid muscles; rapid heartbeat; seeing, hearing or feeling things that are not there; shivering or tremors; sweating; and trouble sleeping.

Possible side effects of Methadone:

All medicines may cause side effects, but many people have no, or minor, side effects. Check with your doctor if any of these most COMMON side effects persist or become bothersome:

Constipation; dizziness; drowsiness; dry mouth; headache; increased sweating; itching; lightheadedness; nausea; vomiting; weakness.

Seek medical attention right away if any of these SEVERE side effects occur:

Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); confusion; decreased sexual desire or ability; excessive drowsiness; fainting; fast, slow, or irregular heartbeat; hallucinations; loss of appetite; menstrual changes; mental or mood changes (eg, agitation, disorientation, exaggerated sense of well-being); seizures; severe or persistent dizziness or lightheadedness; shortness of breath; slow or shallow breathing; swelling of the arms, feet, or legs; trouble sleeping; trouble urinating; unusual bruising or bleeding.

This is not a complete list of all side effects that may occur. If you have questions about side effects, contact your health care provider. Call your doctor for medical advice about side effects. To report side effects to the appropriate agency, please read the Guide to Reporting Problems to FDA.

See also: Methadone side effects (in more detail)

If OVERDOSE is suspected:

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include cold and clammy skin; coma; fainting; fast, slow, or irregular heartbeat; muscle weakness; pinpoint pupils; severe dizziness, drowsiness, or lightheadedness; slow, shallow, or difficult breathing.

Proper storage of Methadone:

Store Methadone between 68 and 77 degrees F (20 and 25 degrees C) in a tightly closed container. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Methadone out of the reach of children and away from pets.

General information:

• If you have any questions about Methadone, please talk with your doctor, pharmacist, or other health care provider.


• Methadone is to be used only by the patient for whom it is prescribed. Do not share it with other people.


• If your symptoms do not improve or if they become worse, check with your doctor.


• Check with your pharmacist about how to dispose of unused medicine.

This information is a summary only. It does not contain all information about Methadone. If you have questions about the medicine you are taking or would like more information, check with your doctor, pharmacist, or other health care provider.

Issue Date: February 1, 2012

Database Edition 12.1.1.002

Copyright © 2012 Wolters Kluwer Health, Inc.

More Methadone resources

• Methadone Side Effects (in more detail)
• Methadone Use in Pregnancy & Breastfeeding
• Drug Images
• Methadone Drug Interactions
• Methadone Support Group
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