Methadone HCl
A to Z Drug Facts
Methadone HCl |
(METH-uh-dohn HIGH-droe-KLOR-ide) |
Dolophine HCl, Methadose |
Class: Narcotic analgesic |
Action Relieves pain by stimulating opiate receptors in CNS; also causes respiratory depression, peripheral vasodilation, inhibition of intestinal peristalsis, sphincter of Oddi spasm, stimulation of chemoreceptors that cause vomiting and increased bladder tone.
Indications Management of severe pain; detoxification and temporary maintenance treatment of narcotic addiction.
Contraindications Standard considerations.
Pain
ADULTS: IM/SC/PO 2.510 mg q 34 hr prn. May need higher doses in patients with severe pain or tolerance.
Detoxification
ADULTS: PO 1520 mg initially to suppress withdrawal symptoms. Additional doses may be needed. PATIENTS PHYSICALLY DEPENDENT ON HIGH DOSES OF NARCOTICS: PO 40 mg/day may be given for 23 days; decrease dose q 12 days. MAINTENANCE: PO 2040 mg initially to suppress withdrawal symptoms in patients who are heavy heroin users. Additional 10 mg doses can be given prn. Adjust dose as tolerated and required, up to 120 mg/day.
Barbiturate anesthetics: Drug actions may be additive. Cimetidine, protease inhibitors: Monitor for increased respiratory and CNS depression. CNS depressants (eg, tranquilizers, sedatives, alcohol): Additive CNS depression. Fluvoxamine: Monitor for increased CNS depression when taken with methadone. Monitor for signs and symptoms of withdrawal when fluvoxamine is discontinued. Hydantoins, rifampin, barbiturates: May decrease effectiveness of methadone. Urinary acidifiers: May increase renal clearance of methadone.
Lab Test Interferences Increased amylase and lipase may occur up to 24 hr after dose.
CV: Hypotension; palpitations; bradycardia; tachycardia. CNS: Lightheadedness; euphoria; dysphoria; headache; insomnia; dizziness; edation; disorientation; incoordination. DERM: Sweating; pruritus; urticaria. GI: Nausea; vomiting; constipation; abdominal pain; dry mouth. GU: Urinary retention or hesitancy. HEMA: Thrombocytopenia. RESP: Laryngospasm; depression of cough reflex. OTHER: Tolerance; psychological and physical dependence with chronic use.
Pregnancy: Pregnancy category undetermined. Methadone use has been associated with low infant birthweight. Lactation: Excreted in breast milk. Children: Not recommended for children; dosage is not well defined. Special risk patients: Use drug with caution in patients with myxedema, acute alcoholism, acute abdominal conditions, ulcerative colitis, decreased respiratory reserve, head injury or increased intracranial pressure, hypoxia, supraventricular tachycardia, depleted blood volume or circulatory shock. Drug dependence: Methadone has abuse potential. Hepatic or renal impairment: May need to decrease dose. Obstetrical analgesia: Do not use methadone for obstetrical analgesia. Its long duration of action increases the probability of neonatal respiratory depression. Treatment of drug addiction: Methadone for detoxification should not be given for > 21 days and treatment should not be repeated within 4 wk. More than 3 wk in methadone treatment of narcotic dependence is considered maintenance therapy; only approved programs can provide this therapy.
PATIENT CARE CONSIDERATIONS |
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Copyright © 2003 Facts and Comparisons
David S. Tatro
A to Z Drug Facts