Methadone

Generic Name: methadone (METH a done)
Brand Names: Diskets, Dolophine, Methadose

What is methadone?

Methadone is a narcotic pain reliever, similar to morphine. Methadone also reduces withdrawal symptoms in people addicted to heroin or other narcotic drugs without causing the "high" associated with the drug addiction.

Methadone is used as a pain reliever and as part of drug addiction detoxification and maintenance programs.

Methadone may also be used for purposes other than those listed in this medication guide.

What is the most important information I should know about methadone?

Taking methadone improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from methadone. Follow all dosing instructions carefully.

Like other narcotic medicines, methadone can slow your breathing, even long after the pain-relieving effects of the medication wear off. Death may occur if breathing becomes too weak. Never use more methadone than your doctor has prescribed. Call your doctor if you think the medicine is not working.

You may have withdrawal symptoms when you stop using methadone after using it over a long period of time. Do not stop using methadone suddenly without first talking to your doctor. You may need to use less and less before you stop the medication completely. Do not drink alcohol while you are taking methadone. It can increase your risk of a fatal overdose. Check the labels of any food or medicines you use to make sure they do not contain alcohol (also called ethanol).

Avoid using drugs that make you sleepy (such as cold medicine, pain medication, sleeping pills, muscle relaxers, and medicine for seizures, depression or anxiety). Methadone may increase the effects of these other drugs and could also result in a fatal overdose.

Methadone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What should I discuss with my healthcare provider before using methadone?

Taking methadone improperly will increase your risk of serious side effects or death. Even if you have used other narcotic medications, you may still have serious side effects from methadone. Follow all dosing instructions carefully. Do not use this medication if you are allergic to methadone, or if you have:

• asthma, COPD, sleep apnea, or other breathing disorders; or

• a stomach condition called paralytic ileus (intestinal blockage).

Before taking methadone, talk to your doctor if you have:

• liver disease;
• kidney disease;

• underactive thyroid;

• curvature of the spine;

• a personal or family history of "Long QT syndrome";

• low blood pressure;

• Addison's disease; or

• a history of drug or alcohol addiction.

If you have any of these conditions, you may not be able to use methadone, or you may need a dosage adjustment or special tests during treatment.

FDA pregnancy category C. Methadone may be harmful to an unborn baby. It could also cause addiction or withdrawal symptoms in a newborn if the mother takes methadone during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant during treatment. Methadone can pass into breast milk and may harm a nursing baby. Do not use methadone without telling your doctor if you are breast-feeding a baby.

Older adults and people with debilitating conditions may be more sensitive to the effects of methadone.

How should I use methadone?

Use methadone exactly as it was prescribed for you. Do not use the medication in larger amounts or for longer than recommended by your doctor. Follow the directions on your prescription label.

Like other narcotic medicines, methadone can slow your breathing, even long after the pain-relieving effects of the medication wear off. Death may occur if breathing becomes too weak. Never use more methadone than your doctor has prescribed. Call your doctor if you think the medicine is not working.

When methadone is used as part of a treatment program for drug addiction or detoxification, you will receive the medication through a clinic or special pharmacy.

Your doctor may recommend that methadone be given to you by a family member or other caregiver. This is to make sure you are using the medicine as it was prescribed as part of your treatment.

Additional forms of counseling and/or monitoring may be recommended during treatment with methadone.

Methadone is available in tablets, dispersible tablets, oral solution (liquid) and as an injection. The pill and oral liquid forms of methadone must never be used to make a methadone injection.

Measure the liquid form of methadone with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The methadone dispersible tablet (Diskets) is made to be dissolved in water. Do not chew, crush, or swallow the tablet whole. Place the tablet into a 4-ounce glass of water, orange juice, or other citrus-flavored non-alcoholic beverage and allow the tablet to disperse in the liquid. The tablet will not dissolve completely. Drink this mixture right away. To make sure you get the entire dose, add a little more liquid to the same glass, swirl gently and drink right away.

Methadone may be habit-forming and should be used only by the person it was prescribed for. Methadone should never be shared with another person, especially someone who has a history of drug abuse or addiction. Keep the medication in a secure place where others cannot get to it. Store methadone at room temperature away from moisture and heat.

Keep track of how many pills have been used from each new bottle of this medicine. Methadone is a drug of abuse and you should be aware if any person in the household is using methadone improperly or without a prescription.

What happens if I miss a dose?

Use the medication as soon as you remember. If it is almost time for the next dose, skip the missed dose and wait until your next regularly scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine. An overdose of methadone can be fatal, especially if you take it with alcohol or other narcotic medications.

Symptoms of a methadone overdose may include slow heart rate, small pupils, cold, clammy skin, coma, weak or shallow breathing, or breathing that stops.

What should I avoid while using methadone?

Do not drink alcohol while you are taking methadone. It can increase your risk of a fatal overdose. Check the labels of any food or medicines you use to make sure they do not contain alcohol (also called ethanol).

Avoid using drugs that make you sleepy (such as cold medicine, pain medication, muscle relaxants, and medicine for seizures, depression or anxiety). Methadone may increase the effects of these other drugs and could also result in a fatal overdose.

Methadone can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.

What are the possible side effects of methadone?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Call your doctor at once if you have any of these serious side effects:

• shallow breathing;

• hallucinations or confusion; or

• fast or pounding heartbeats, chest pain, trouble breathing, feeling light-headed, fainting.

Other, less serious side effects may be more likely to occur, such as:

• feeling anxious, nervous, or restless;

• sleep problems (insomnia);

• dizziness, drowsiness, or weakness;

• dry mouth, nausea, vomiting, diarrhea, constipation, loss of appetite; or

• decreased sex drive, impotence, or difficulty having an orgasm.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect methadone?

Do not use methadone with any of the following drugs without first talking to your doctor:

• a diuretic (water pill);

• antibiotics such as azithromycin (Zithromax), ciprofloxacin (Cipro), clarithromycin (Biaxin), erythromycin (E-Mycin, Ery-Tab), itraconazole (Sporanox), ketoconazole (Nizoral), metronidazole (Flagyl) or voriconazole (Vfend);

• heart or blood pressure medication such as diltiazem (Cardizem, Dilacor, Tiazac) or verapamil (Calan, Covera, Isoptin, Verelan);

• HIV medicines such as abacavir (Ziagen), amprenavir (Agenerase), didanosine (Videx), efavirenz (Sustiva), lopinavir/ritonavir (Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir), stavudine (Zerit), or zidovudine (Retrovir);

• an MAO inhibitor such as isocarboxazid (Marplan), tranylcypromine (Parnate), phenelzine (Nardil), or selegiline (Eldepryl, Emsam);

• other narcotic medications such as pentazocine (Talwin), nalbuphine (Nubain), buprenorphine (Subutex), or butorphanol (Stadol);

• rifampin (Rifadin, Rimactane, Rifater); or

• seizure medication such as phenobarbital (Luminal, Solfoton) or phenytoin (Dilantin).

If you are using any of these drugs, you may not be able to use methadone, or you may need dosage adjustments or special tests during treatment.

There are many other medicines that may cause serious medical problems if you take them together with methadone. Tell your doctor about all the prescription and over-the-counter medications you use. This includes vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start using a new medication without telling your doctor. Keep a list with you of all the medicines you use and show this list to any doctor or other healthcare provider who treats you.

Where can I get more information?

• Your pharmacist has information about methadone written for health professionals that you may read.

What does my medication look like?

Methadone is available with a prescription under the brand names Dolophine and Methadose. Other brand or generic formulations may also be available. Ask your pharmacist any questions you have about methadone, especially if it is new to you.

• Every effort has been made to ensure that the information provided is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects.