Methadone: Difference between revisions
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==Adult Dosing== | ==Adult Dosing== | ||
*Varies widely due to patient variability in ADME, tolerance, indication | |||
* | |||
*Usual doses: | *Usual doses: | ||
**Opioid use disorder, maintenance: 40-120mg/day | **Opioid use disorder, maintenance: 40-120mg/day or higher | ||
**Pain: initial dose 2.5mg TID for opioid naive | **Pain: initial dose 2.5mg TID for opioid naive | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
'' | ''Safety/efficacy not established in pediatric patients'' | ||
*0.1-0.2mg/kg q6h | *0.1-0.2mg/kg q6h | ||
==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: Category C | ||
*[[Lactation risk categories|Lactation risk]]: infant risk minimal | *[[Lactation risk categories|Lactation risk]]: infant risk minimal | ||
===Renal Dosing=== | ===Renal Dosing=== | ||
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===Serious=== | ===Serious=== | ||
*[[QTc prolongation]] | *[[QTc prolongation]] | ||
*[[ | *[[Torsades de pointes]] | ||
* | *Respiratory depression/acidosis/arrest | ||
===Common=== | ===Common=== | ||
* | *[[Constipation]] | ||
*[[Nausea/vomiting]] | |||
*Sedation | |||
*[[Dizziness]] | |||
*[[Hypotension]] | |||
==Pharmacology== | ==Pharmacology== | ||
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==Mechanism of Action== | ==Mechanism of Action== | ||
* | *Synthetic opioid | ||
==Comments== | ==Comments== | ||
Latest revision as of 19:30, 4 October 2023
Administration
- Type: opioid
- Dosage Forms:
- Routes of Administration: oral, IM/subcutaneous
- Common Trade Names:
Adult Dosing
- Varies widely due to patient variability in ADME, tolerance, indication
- Usual doses:
- Opioid use disorder, maintenance: 40-120mg/day or higher
- Pain: initial dose 2.5mg TID for opioid naive
Pediatric Dosing
Safety/efficacy not established in pediatric patients
- 0.1-0.2mg/kg q6h
Special Populations
- Pregnancy Rating: Category C
- Lactation risk: infant risk minimal
Renal Dosing
- Adult: lower initial starting dose
Hepatic Dosing
- Adult: lower initial starting dose
Contraindications
- Allergy to class/drug
Adverse Reactions
Serious
- QTc prolongation
- Torsades de pointes
- Respiratory depression/acidosis/arrest
Common
- Constipation
- Nausea/vomiting
- Sedation
- Dizziness
- Hypotension
Pharmacology
- Half-life: 8-59 hours
- Metabolism: mostly hepatic
Mechanism of Action
- Synthetic opioid