Methadone
Brand: Dolophine, Methadose
Boxed warning · ISMP high-alert drug
Addiction, abuse, and misuse; life-threatening respiratory depression; profound sedation and death with benzodiazepines or other CNS depressants; neonatal opioid withdrawal syndrome with prolonged use in pregnancy. Also QT prolongation and serious arrhythmias, and accidental ingestion.
- Caution
- Long and variable half-life: overdose can build up during dose adjustment, and opioid use disorder dispensing runs through certified programs.
- Pregnancy
- Prolonged use in pregnancy causes neonatal opioid withdrawal syndrome (boxed).
Common side effects
- Constipation
- Sedation
- Sweating
- QT prolongation
Key interactions
- Additive sedation with benzodiazepines
- Additive QT risk with other QT-prolonging drugs
- Many enzyme inducers lower its level
Counseling points
- Long and variable half-life, never take extra doses
- ECG monitoring may be required
- Dispensing for opioid use disorder runs through certified programs
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High-yield study aid for exam prep, not a substitute for the package insert or a pharmacist’s dispensing reference.