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Methadone Treatment: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Methadone is a prescription medication used to treat opioid use disorder, manage severe pain, and alleviate withdrawal symptoms. It works by altering the brain’s response to pain and reducing opioid cravings. Methadone should only be taken under the supervision of a healthcare provider due to the potential for serious side effects. If you’re considering methadone treatment, consult one of our telemedicine providers for personalized guidance.
Names of Medication
US Brand Name: Dolophine (Methadone)
The generic name refers to the chemical composition of the medication, while the brand name is assigned by the manufacturer. In this article, the generic name is shown in parentheses.
Pharmacologic Category
Opioid Analgesic
Opioid Agonist
Methadone Dosing
Methadone is prescribed for various conditions. Always follow your healthcare provider’s instructions and never adjust your dose without consulting them. You can schedule an appointment with one of our telemedicine providers for advice on your treatment plan.
Methadone for Opioid Use Disorder
Initial Dose: 20-30 mg orally once daily.
Maintenance Dose: 60-120 mg once daily, adjusted based on response.
Duration: Long-term treatment, as directed by your healthcare provider.
Methadone for Chronic Pain
Initial Dose: 2.5-10 mg every 8-12 hours.
Maintenance Dose: Adjusted based on pain control and tolerance.
Duration: As long as pain persists, under close supervision.
Methadone for Cancer Pain
Initial Dose: 2.5-10 mg every 8-12 hours.
Maintenance Dose: Adjusted based on pain severity and patient response.
Duration: As needed for pain management, under medical supervision.
Methadone for Neuropathic Pain
Initial Dose: 2.5-5 mg every 8-12 hours.
Maintenance Dose: Adjusted based on pain relief and tolerance.
Duration: Long-term, based on the patient’s condition.
Methadone in Palliative Care
Initial Dose: 2.5-10 mg every 8-12 hours.
Maintenance Dose: Adjusted based on symptom relief.
Duration: As needed for comfort care.
Methadone for Heroin Addiction
Initial Dose: 20-30 mg orally once daily.
Maintenance Dose: 60-120 mg once daily, adjusted based on response.
Duration: Long-term, as directed by your healthcare provider.
Methadone for Prescription Opioid Addiction
Initial Dose: 20-30 mg orally once daily.
Maintenance Dose: 60-120 mg once daily, adjusted based on response.
Duration: Long-term, as directed by your healthcare provider.
Methadone for Severe Pain
Initial Dose: 2.5-10 mg every 8-12 hours.
Maintenance Dose: Adjusted based on pain control and tolerance.
Duration: As long as pain persists, under close supervision.
Methadone for Withdrawal Symptoms
Initial Dose: 20-30 mg orally once daily.
Maintenance Dose: 60-120 mg once daily, adjusted based on response.
Duration: Long-term, as directed by your healthcare provider.
Methadone for Fibromyalgia
Initial Dose: 2.5-5 mg every 8-12 hours.
Maintenance Dose: Adjusted based on symptom relief and tolerance.
Duration: Long-term, based on patient response.
Dosage Forms and Strengths
Oral Tablet: 5 mg, 10 mg
Oral Solution: 5 mg/5 mL, 10 mg/5 mL
Oral Concentrate: 10 mg/mL
Injectable Solution: 10 mg/mL
Administration Instructions for Methadone
Methadone should be taken exactly as prescribed by your healthcare provider. It can be taken with or without food, but it’s important to take it at the same time each day to maintain consistent levels in your body. Do not crush or chew the tablets, as this can release the medication too quickly, increasing the risk of side effects. If you miss a dose, take it as soon as you remember, unless it’s close to your next dose. Never double up on doses. Contact your healthcare provider if you have any questions or concerns about how to take methadone.
Contraindications for Methadone
A contraindication is a specific situation or condition where a particular treatment, such as a medication, should not be used because it may cause harm. In the case of methadone, there are several contraindications that patients and healthcare providers need to be aware of.
Severe respiratory issues: Methadone can slow breathing, which is dangerous for people with severe asthma, chronic obstructive pulmonary disease (COPD), or other breathing problems.
Heart rhythm disorders: Methadone can cause QT prolongation, a condition affecting the heart’s electrical activity. If you have a history of heart rhythm problems, methadone may not be safe for you.
Allergic reaction to methadone: If you’ve had an allergic reaction to methadone, you should not take it again, as it could lead to severe symptoms like difficulty breathing, swelling, or rash.
Severe liver disease: Methadone is processed by the liver, so if you have severe liver disease, it may not be safe to take this medication, as it could build up to dangerous levels in your body.
Paralytic ileus: This condition, where the intestines stop moving food through the digestive system, can be worsened by methadone, making it contraindicated.
Drug-to-Drug Interactions with Methadone
Some medications can interact with methadone, either increasing the risk of side effects or reducing its effectiveness. It’s important to inform your healthcare provider about all the medications you are taking, including over-the-counter drugs and supplements. Below are some common medications that may interact with methadone:
- Benzodiazepines: Medications like Xanax (alprazolam), Valium (diazepam), and Ativan (lorazepam) can increase the risk of severe respiratory depression when taken with methadone.
- Antidepressants: Certain antidepressants, such as Prozac (fluoxetine) or Zoloft (sertraline), can increase the risk of serotonin syndrome, a potentially life-threatening condition.
- Antifungal medications: Drugs like Diflucan (fluconazole) and Nizoral (ketoconazole) can increase methadone levels in the blood, raising the risk of side effects.
- Antibiotics: Some antibiotics, such as Biaxin (clarithromycin) and Erythrocin (erythromycin), can also increase methadone levels in the blood.
- HIV medications: Protease inhibitors like Norvir (ritonavir) and Sustiva (efavirenz) can interact with methadone, either increasing or decreasing its effectiveness.
Methadone in Pregnancy
Is it Safe to Take Methadone When Pregnant?
Methadone is sometimes prescribed during pregnancy to manage opioid use disorder, as it helps prevent withdrawal symptoms in both the mother and baby. However, Methadone can cross the placenta, potentially leading to neonatal abstinence syndrome (NAS), where the newborn may experience withdrawal symptoms after birth. The decision to use Methadone during pregnancy should be made in close consultation with your healthcare provider, who will carefully weigh the benefits and risks. If you are pregnant and taking Methadone, regular monitoring by your healthcare team is essential to ensure the best outcomes for both you and your baby.
Methadone While Breastfeeding
Is it Safe to Take Methadone While Breastfeeding?
Methadone passes into breast milk in small amounts. For most women, breastfeeding while on Methadone is considered safe, as the benefits of breastfeeding often outweigh the potential risks. However, it’s important to monitor your baby for any signs of drowsiness, feeding difficulties, or breathing problems. Always consult your healthcare provider before making any decisions about breastfeeding while taking Methadone to ensure it is the right choice for you and your baby.
Estimated Cost of Methadone Treatment
The cost of Methadone can vary depending on where it’s purchased and whether you have insurance coverage. Without insurance, a 30-day supply of Methadone using a GoodRx coupon is estimated to cost between $20 and $40, depending on the dosage and pharmacy location. For the most accurate pricing, check with your local pharmacy.
Possible Alternatives to Methadone
If Methadone isn’t the right option for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to discuss these options in more detail.
Opioid Use Disorder
Alternatives include buprenorphine (Suboxone) or naltrexone (Vivitrol). Behavioral therapy and support groups can also play a crucial role in managing opioid addiction.
Chronic Pain
Non-opioid pain relievers like acetaminophen or ibuprofen, physical therapy, and lifestyle changes such as regular exercise and stress management may help alleviate chronic pain.
Cancer Pain
Other opioid medications, non-opioid pain relievers, and palliative care services can be considered as alternatives to Methadone for managing cancer-related pain.
Neuropathic Pain
Medications like gabapentin (Neurontin) or pregabalin (Lyrica) are often used to manage nerve pain, offering an alternative to Methadone.
Palliative Care
In addition to Methadone, other opioids or non-opioid medications may be used, along with holistic care approaches such as counseling and physical therapy, to provide comprehensive palliative care.
Heroin Addiction
Buprenorphine (Suboxone) and naltrexone (Vivitrol) are common alternatives to Methadone for treating heroin addiction. Behavioral therapy and support groups are also essential components of a successful treatment plan.
Prescription Opioid Addiction
Similar to heroin addiction, buprenorphine (Suboxone) and naltrexone (Vivitrol) are alternatives, along with counseling and support groups, for managing prescription opioid addiction.
Severe Pain
Other opioid medications, non-opioid pain relievers, and physical therapy may be considered as alternatives to Methadone for managing severe pain.
Withdrawal Symptoms
Buprenorphine (Suboxone) and clonidine are commonly used to manage withdrawal symptoms, offering alternatives to Methadone in opioid replacement therapy.
Fibromyalgia
Non-opioid medications like duloxetine (Cymbalta) or pregabalin (Lyrica), along with lifestyle changes such as regular exercise and stress management, may help manage fibromyalgia symptoms.
Recent Updates on Methadone Research
Recent research on Methadone has focused on improving its use in treating opioid use disorder and chronic pain while minimizing side effects. Studies continue to show that Methadone remains an effective treatment for opioid addiction, but ongoing research aims to reduce the risk of overdose, particularly when Methadone is combined with other medications like benzodiazepines. Researchers are also exploring individualized dosing strategies to improve patient outcomes and reduce side effects, such as QT prolongation, a heart rhythm issue.
There is also growing interest in developing new Methadone formulations, such as extended-release options, which could reduce the need for frequent dosing and improve patient adherence. As research progresses, staying informed about new developments is important. You can always discuss the latest findings with one of our healthcare providers through a telemedicine appointment.
