Methadone Oral

(meth’ a done)

IMPORTANT WARNING:

Why is this medication prescribed?

Methadone is used to relieve severe pain. It also is used to prevent withdrawal symptoms in patients who were addicted to opiate drugs and are enrolled in treatment programs in order to stop taking or continue not taking the drugs. Methadone is in a class of medications called opiate (narcotic) analgesics. Methadone works to treat pain by changing the way the brain and nervous system respond to pain. It also works as a substitute for opiate drugs of abuse by producing similar effects and preventing withdrawal symptoms in people who have stopped taking these drugs.

How should this medicine be used?

Methadone comes as a tablet, a dispersible tablet (can be dissolved in liquid), a solution (liquid), and a concentrated solution (liquid that must be diluted before use) to take by mouth. For the relief of pain, it may be taken every 4-12 hours. 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.

Your doctor may change your dose of methadone during your treatment. Your doctor may decrease your dose or tell you to take methadone less often as your treatment continues. Ask your doctor or pharmacist if you have any questions about how much methadone you should take or how often you should take the medication.

Methadone can be habit-forming. Do not take a larger dose, take it more often, or take it for a longer period than prescribed by your doctor . Call your doctor if you find that you want to take extra medication or notice any other unusual changes in your behavior or mood.

Do not stop taking methadone without talking to your doctor. Your doctor will probably want to decrease your dose gradually. If you suddenly stop taking methadone, you may experience withdrawal symptoms such as restlessness, teary eyes, runny nose, yawning, sweating, chills, muscle pain, and widened pupils (black circles in the middle of the eyes).

If you are using the dispersible tablets, place one tablet in a liquid such as water or citrus fruit juice.Wait 1 minute to allow the tablet to dissolve and then drink the entire mixture.

If you are using methadone oral concentrate solution, you should mix your prescribed dose of medication in at least 1 ounce of liquid such as water, citrus fruit juice, Kool Aid^®, Tang^®, apple juice, or Crystal Light^®.

Other uses for this medicine

This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.

What special precautions should I follow?

Before taking methadone,

• tell your doctor and pharmacist if you are allergic to methadone or any other medications.
• tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following:certain antiarrhythmics such as amiodarone (Cordarone, Pacerone), disopyramide (Norpace), procainamide (Procanbid, Pronestyl), quinidine (Quinidex), sotalol (Betapace); antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), bupropion (Wellbutrin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), fluoxetine (Prozac, Sarafem), fluvoxamine (Luvox), imipramine (Tofranil), nefazodone, nortriptyline (Aventyl, Pamelor), paroxetine (Paxil), protriptyline (Vivactil), sertraline (Zoloft), trimipramine (Surmontil), and venlafaxine (Effexor); certain antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend); antihistamines; aprepitant (Emend);buprenorphine (Subutex); butorphanol (Stadol NS); calcium channel blocking agents such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Covera, Isoptin, Verelan); chlorpheniramine (antihistamine in allergy and cold medications); cimetidine (Tagamet);clarithromycin (Biaxin, in Prevpac);cyclosporine (Neoral, Sandimmune);dexamethasone (Decadron, Dexpak);diuretics (’water pills’); erythromycin (E.E.S., E-Mycin, Erythrocin);griseofulvin (Fulvicin, Grifulvin, Gris-PEG); haloperidol (Haldol);hormonal contraceptives (birth control pills, rings, implants, injections, and patches); isoniazid (INH, Laniazid, Nydrazid); laxatives; lovastatin (Altocor, Mevacor); medications for anxiety, mental illness, nausea, or pain; medications for HIV including atazanavir (Reyataz),delaviridine (Rescriptor), didanosine (Videx),efavirenz (Sustiva), indinavir (Crixivan), lopinavir (in Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, in Kaletra), saquinavir (Fortovase, Invirase),stavudine (Zerit), and zidovudine (Retrovir);certain medications for seizures such as carbamazepine (Carbatrol, Epitol, Tegretol),phenytoin (Dilantin, Phenytek); phenobarbital (Luminal, Solfoton); metoclopramide (Reglan); naloxone (Narcan);naltrexone (ReVia, Depade); pentazocine (Talwin); qquinolones such as ciproflaxacin (Cipro), gatifloxacin (Tequin), levofloxacin (Levaquin), lomefloxacin (Maxequin), norfloxacin (Noroxin), ofloxacin (Floxin), and sparfloxacin (Zagam); rifabutin (Mycobutin);rifampin (Rifadin, Rimactane, in Rifamate); risperidone (Risperdal); sedatives; sleeping pills; ticlopidine (Ticlid); theophylline (Theo-Dur, Slo-bid, others); tranquilizers; troleandomycin (TAO);and zafirlukast (Accolate).Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them in the past 14 days: monoamine oxidase (MAO) inhibitors including isocarboxazid (Marplan,), phenelzine (Nardil), selegiline (Eldepryl), and tranylcypromine (Parnate). Many other medications may also interact with methadone, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
• tell your doctor what herbal products you are taking especially St. John’s wort.
• tell your doctor if you have or have ever had a head injury, a brain tumor, a stroke or any other condition that caused high pressure inside your skull; irregular heartbeat; asthma, lung disease, or breathing problems;urethral stricture (narrowing of the tube that carries urine out of the body), enlarged prostate (a male reproductive gland), or any other condition that causes difficulty urinating; Addison’s disease (a condition in which the body does not make enough of certain natural substances); or thyroid , heart, liver, or kidney disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol or if you use or have ever used street drugs or have overused prescription medications.
• tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking methadone, call your doctor.
• if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methadone.
• you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
• remember that alcohol can add to the drowsiness caused by this medication.
• tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
• you should know that methadone may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking methadone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

What special dietary instructions should I follow?

Talk to your doctor about eating grapefruit and drinking grapefruit juice while taking this medicine.

What should I do if I forget a dose?

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.

What side effects can this medication cause?

Methadone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

• drowsiness
• weakness
• headache
• upset stomach
• vomiting
• constipation
• loss of appetite
• stomach pain
• dry mouth
• sweating
• flushing
• difficulty urinating
• mood changes
• confusion
• vision problems
• difficulty falling asleep or staying asleep
• decreased sexual desire or ability

Some side effects can be serious. If you experience any of the following symptoms, call your doctor immediately:

• chest pain
• slowed or difficult breathing
• slow or pounding heartbeat
• dizziness
• lightheadedness
• fainting
• swelling of the arms, hands, feet, ankles, or lower legs
• itching
• hives
• rash

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online [at http://www.fda.gov/MedWatch/report.htm] or by phone [1-800-332-1088].

What storage conditions are needed for 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.

Store methadone in a safe place so that no one else can take it accidentally or on purpose. Keep track of how many tablets or how much solution or concentrated solution is left so you will know if any is missing.

In case of emergency/overdose

See theMedWatch notification at the beginning of the monograph.

In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at 911.

Symptoms of overdose may include:

• small, pinpoint pupils (black circles in the center of the eyes)
• difficulty in breathing
• drowsiness
• cool, clammy skin
• loss of consciousness; coma
• loss of muscle tone

What other information should I know?

Keep all appointments with your doctor, laboratory, and clinic. Your doctor will want to check your response to methadone.

This prescription is not refillable. If you continue to experience pain after you finish methadone, call your doctor. If you take this medication on a regular basis, be sure to schedule appointments with your doctor so that you do not run out of medication.

Brand names

Last Revised - 01/01/2007

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This entry was posted on Friday, February 23rd, 2007 at 10:33 pm and is filed under Drug Information. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.