Methadone - Revision history

Helen at 07:35, 5 October 2020

2020-10-05T07:35:18Z

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	[[Category: Drugs]] [[Category: Non-opioid Analgesic]] [[Category: opioid analgesic ]]		[[Category: Drugs]] [[Category: Non-opioid Analgesic]] [[Category: opioid analgesic ]]
			==Introduction==
	'''Methadone''' is an opioid analgesic. Methadone hydrochloride is used in the treatment of moderate to severe pain; it may be of use for those patients who have excitation or exacerbation of pain with morphine. Methadone is also used in the management of opioid dependence.		'''Methadone''' is an opioid analgesic. Methadone hydrochloride is used in the treatment of moderate to severe pain; it may be of use for those patients who have excitation or exacerbation of pain with morphine. Methadone is also used in the management of opioid dependence.

Helen at 04:18, 5 October 2020

2020-10-05T04:18:47Z

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	\|It has a prolonged half-life and is subject to accumulation. Elimination half-lives vary considerably ( a range of 15 to 60 hours has been quoted).		\|It has a prolonged half-life and is subject to accumulation. Elimination half-lives vary considerably ( a range of 15 to 60 hours has been quoted).
	\|}		\|}

			==Drug Management==
			===Efficiency===
			Pain control
			===Safety===
			mental status, blood pressure, respiratory drive, and misuse / overuse.
			===Precautions===
			methadone should be given with caution to patients at risk of developing prolongation of the QT interval including those with cardiac or hepatic disease, with hypokalaemia or other electrolyte imbalance. ECG monitoring is recommended before starting methadone treatment in these patients.
			===Drug Interaction===
			Increase risk of serotonin syndrome when used with SNRI, TCA, linezolid.
			===Caution===
			History of cardia conduction abnormalities
			Tolerance and dependence
			===Contraindication===
			Phaeochromocytoma

			== FAQ ==
			=== How should I take the tablet? ===
			Follow the doctor's prescription,
			Take with or without food
			Take the medication with plenty of water
			Can be crushed
			=== What should I avoid while taking? ===
			Avoid abrupt withdrawal
			=== What happen if I miss a dose? ===
			Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Helen at 04:15, 5 October 2020

2020-10-05T04:15:30Z

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	Euphoria, nausea and vomiting, respiratory depression, constipation and cough suppression, QT prolongation, increase intracranial pressure.		Euphoria, nausea and vomiting, respiratory depression, constipation and cough suppression, QT prolongation, increase intracranial pressure.

			==Pharmacokinetics==

			{\|class="wikitable"
			!Oral bioavailability
			\|Methadone is readily absorbed from the gastrointestinal tract and after subcutaneous or intramuscular injections. It crosses the placenta and is distributed into breast milk.
			\|-
			!Onset of action
			\|In addition to marked interindividual variations there are differences in the pharmacokinetics of methadone after single or multiple doses. Careful adjustment of dosage is necessary with repeated doses.
			\|-
			!Metabolism
			\|Methadone is metabolized in the liver, and is excreted in the urine.
			\|-
			!Elimination half-life
			\|It has a prolonged half-life and is subject to accumulation. Elimination half-lives vary considerably ( a range of 15 to 60 hours has been quoted).
			\|}

Helen at 04:13, 5 October 2020

2020-10-05T04:13:45Z

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	\|}		\|}

			==Side Effects==
			Methadone has a more prolonged effect than morphine and readily accumulates with repeated doses. Repeated doses of methadone may result in marked sedation.

			Euphoria, nausea and vomiting, respiratory depression, constipation and cough suppression, QT prolongation, increase intracranial pressure.

Helen: /* Dosage */

2020-10-05T04:13:10Z

Dosage

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	\|5-10mg q6-8h PRN		\|5-10mg q6-8h PRN
	\|-		\|-
	\|
	!Opioid dependence		!Opioid dependence
	\|initally 10-30mg on first day, adjusted according to response		\|initally 10-30mg on first day, adjusted according to response

	\|}		\|}

Helen: /* Dosage */

2020-10-05T04:12:59Z

Dosage

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	!Severe pain		!Severe pain
	\|5-10mg q6-8h PRN		\|5-10mg q6-8h PRN
			\|-
			\|
	!Opioid dependence		!Opioid dependence
	\|initally 10-30mg on first day, adjusted according to response		\|initally 10-30mg on first day, adjusted according to response

	\|}		\|}

Helen: /* Dosage */

2020-10-05T04:12:41Z

Dosage

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	Methadone is not licensed for use in children.		Methadone is not licensed for use in children.

			{\|class="wikitable"

			!Severe pain
			\|5-10mg q6-8h PRN
			!Opioid dependence
			\|initally 10-30mg on first day, adjusted according to response

			\|}

Helen: /* Dosage */

2020-10-05T04:11:31Z

Dosage

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	Intramuscular, intravenous and subcutaneous route being recommended for prolonged use. The analgesic effect of methadone begins about 10 to 20 minutes after parenteral injection and about 30 to 60 minutes after oral doses, the effect of a single dose usually lasting about 4 hours. As accumulation occurs with repeated doses, the effects more prolonged. Consequently, to avoid the risk of opioid overdose, it is recommended that in prolonged use methadone should not be given more than twice daily.		Intramuscular, intravenous and subcutaneous route being recommended for prolonged use. The analgesic effect of methadone begins about 10 to 20 minutes after parenteral injection and about 30 to 60 minutes after oral doses, the effect of a single dose usually lasting about 4 hours. As accumulation occurs with repeated doses, the effects more prolonged. Consequently, to avoid the risk of opioid overdose, it is recommended that in prolonged use methadone should not be given more than twice daily.

			For the treatment of '''opioid dependence,

			{\|class="wikitable"

			!Oral
			\|starting dose of 10 to 40 mg daily, to suppress signs of opioid withdrawal. Most patients in such maintenance programmes are stabilized on once-daily doses of 60 to 120 mg.

			\|}

			Methadone is not licensed for use in children.

Helen: /* Dosage */

2020-10-05T04:08:09Z

Dosage

← Older revision		Revision as of 00:08, 5 October 2020
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	For pain relief		For pain relief

			{\|class="wikitable"

	!Oral		!Oral
	\|starting dose range from 2.5 to 10mg every 6 to 8 hours or longer, adjusted as necessary.		\|starting dose range from 2.5 to 10mg every 6 to 8 hours or longer, adjusted as necessary.

			\|}

	Intramuscular, intravenous and subcutaneous route being recommended for prolonged use. The analgesic effect of methadone begins about 10 to 20 minutes after parenteral injection and about 30 to 60 minutes after oral doses, the effect of a single dose usually lasting about 4 hours. As accumulation occurs with repeated doses, the effects more prolonged. Consequently, to avoid the risk of opioid overdose, it is recommended that in prolonged use methadone should not be given more than twice daily.		Intramuscular, intravenous and subcutaneous route being recommended for prolonged use. The analgesic effect of methadone begins about 10 to 20 minutes after parenteral injection and about 30 to 60 minutes after oral doses, the effect of a single dose usually lasting about 4 hours. As accumulation occurs with repeated doses, the effects more prolonged. Consequently, to avoid the risk of opioid overdose, it is recommended that in prolonged use methadone should not be given more than twice daily.

Helen at 04:07, 5 October 2020

2020-10-05T04:07:30Z

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	\|IV		\|IV
	\|}		\|}

			==Dosage==

			For pain relief

			!Oral
			\|starting dose range from 2.5 to 10mg every 6 to 8 hours or longer, adjusted as necessary.

			Intramuscular, intravenous and subcutaneous route being recommended for prolonged use. The analgesic effect of methadone begins about 10 to 20 minutes after parenteral injection and about 30 to 60 minutes after oral doses, the effect of a single dose usually lasting about 4 hours. As accumulation occurs with repeated doses, the effects more prolonged. Consequently, to avoid the risk of opioid overdose, it is recommended that in prolonged use methadone should not be given more than twice daily.