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Allergies-
Tell your doctor and pharmacist if you are allergic to codeine,
methadone, or any other drugs.
Pregnancy-
- Safe use in pregnancy has not been
established in relation to possible adverse effects on fetal
development. Therefore, methadone should not be used in pregnant women
unless, in the judgment of the physician, the potential benefits
outweigh the possible hazards.
- Methadone is not recommended for
obstetric analgesia because its long duration of action increases the
probability of respiratory depression in the newborn.
Breast-feeding-
Most narcotic analgesics have not been reported to cause problems in
nursing babies. However, when the mother is taking large amounts of
methadone, the nursing baby may become dependent on the medicine.
Children-
Methadone is not recommended for use as an analgesic in children,
since documented clinical experience has been insufficient to establish
a suitable dosage regimen for the pediatric age group.
Older adults-
Elderly people are especially sensitive to the effects of narcotic
analgesics. This may increase the chance of side effects, especially
breathing problems, during treatment.
Other medicines-
Although certain medicines
should not be used together at all, in other cases two different
medicines may be used together even if an interaction might occur. In
these cases, your doctor may want to change the dose, or other
precautions may be necessary. When you are taking a narcotic analgesic,
it is especially important that your health care professional know if
you are taking any of the following:
- Central nervous system (CNS)
depressants or
- Monoamine oxidase (MAO) inhibitors
(furazolidone [e.g., Furoxone], isocarboxazid [e.g., Marplan],
pargyline [e.g., Eutonyl], phenelzine [e.g., Nardil], procarbazine
[e.g., Matulane], tranylcypromine [e.g., Parnate] (taken currently or
within the past 2 weeks) or
- Tricyclic antidepressants
(amitriptyline [e.g., Elavil], amoxapine [e.g., Asendin], clomipramine
[e.g., Anafranil], desipramine [e.g., Pertofrane], doxepin [e.g.,
Sinequan], imipramine [e.g., Tofranil], nortriptyline [e.g., Aventyl],
protriptyline [e.g., Vivactil], trimipramine [e.g., Surmontil])
- Naltrexone (e.g., Trexan)—Narcotics
will not be effective in people taking naltrexone
- Rifampin (e.g., Rifadin)—Rifampin
decreases the effects of methadone and may cause withdrawal symptoms
in people who are dependent on methadone
Other medical problems-
The presence of other medical
problems may affect the use of narcotic analgesics. Make sure you tell
your doctor if you have any other medical problems, especially:
- Alcohol abuse, or history of, or
- Drug dependence, especially narcotic
abuse, or history of, or
- Emotional problems—The chance of
side effects may be increased; also, withdrawal symptoms may occur if
a narcotic you are dependent on is replaced by buprenorphine,
butorphanol, nalbuphine, or pentazocine
- Brain disease or head injury or
- Emphysema, asthma, or other chronic
lung disease or
- Enlarged prostate or problems with
urination or
- Gallbladder disease or
gallstones—Some of the side effects of narcotic analgesics can be
dangerous if these conditions are present
- Colitis or
- Heart disease or
- Kidney disease or
- Liver disease or
- Underactive thyroid—The chance of
side effects may be increased
- Convulsions (seizures), history
of—Some of the narcotic analgesics can cause convulsions
Proper Use of This Medicine
- Methadone comes as a tablet,
dispersible tablet, liquid, and liquid concentrate to take by mouth.
It usually is taken every 3-4 hours as necessary for severe pain or
every 6-8 hours for chronic pain. If you take methadone as part of a
treatment program, your doctor will prescribe the dosing schedule that
is best for you. 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.
- Methadone can be habit-forming. Do
not take a larger dose, take it more often, or for a longer period
than your doctor tells you to.
- Dispersible tablets should be put in
3-4 ounces of liquid (e.g., water or citrus fruit juice) before use.
The tablet should be completely dissolved in 1 minute.
- When the methadone oral concentrate
solution is used, the dose should be mixed in 3-4 ounces of liquid
(e.g., water or citrus fruit juice) first.
- If you take methadone as part of a
treatment program, you must go to an approved clinic to obtain (and
sometimes take) the drug. Your doctor will tell you about the proper
procedures for enrolling in this kind of treatment program.
Dosing-
For Relief of Pain --Dosage should be adjusted according
to the severity of the pain and the response of the patient.
Occasionally, it may be necessary to exceed the usual dosage recommended
in cases of exceptionally severe pain or in those patients who have
become tolerant to the analgesic effects of narcotics. The usual adult
dosage is 2.5 mg to 10 mg every 3 or 4 hours as necessary.
Missed dose-
Methadone may be taken as needed. 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.
Storage-
To store this medicine:
- 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.
Side Effects of This Medicine
Although side effects from
methadone are not common, they can occur. Tell your doctor if any of
these symptoms are severe or do not go away:
- dizziness
- lightheadedness
- drowsiness
- upset stomach
- vomiting
- constipation
- stomach pain
- rash
- difficulty urinating
If you experience either of the
following symptoms, call your doctor immediately:
- difficulty breathing
- fainting
Some commonly used brand names are:
In the U.S.-
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