Avoiding Accidental Overdoses with Methadone

FDA has issued a Public Health Advisory cautioning practitioners about avoiding overdoses when they are prescribing methadone or managing patients taking this drug. Since the 1970s, methadone has been primarily used in treating drug abuse, but now it's also being used increasingly for the treatment of pain.

FDA issued the Advisory because of reports of life-threatening adverse events and death in patients receiving methadone for pain control. Part of the reason is that physicians prescribing methadone for pain relief may not fully understand the drug's pharmacology and potential adverse effects. For example, methadone, like other opioids, causes respiratory depression. But in addition, it can also have effects on cardiac conduction, leading to prolonged QT intervals and serious arrhythmias.
Methadone also interacts with many other drugs, some of which can slow methadone's elimination from the body and thus increase the likelihood of overdose and adverse effects related to either respiratory depression or cardiac arrhythmias.

Overdoses can also occur because methadone remains in the body much longer than the drug's analgesic effect lasts. So if a patient takes more methadone to extend the duration of pain relief, he or she may be at serious risk of respiratory depression.

The Advisory lists several recommendations for health care professionals, including closely monitoring patients on this drug, especially when starting treatment or adjusting the dose. This should be done even for patients who are opioid-tolerant.

Because many patients will be taking the methadone at home without medical supervision, much of the responsibility for avoiding overdoses rests with patients and caregivers. Because of this, FDA is working on a Medication Guide for patients, to be distributed when prescriptions for methadone are dispensed.

In the meantime, health care professionals should refer patients to the Patient Package Insert for advice on how to use the drug safely. Here's what patients should know if they take methadone for pain relief:

• First, don't take more of the drug than prescribed. If pain isn't relieved at the prescribed dose, call your doctor.

• Be aware that pain relief may take a few days after you start the drug.

• Get medical attention right away if you experience palpitations, dizziness, lightheadedness or fainting.

• And be sure to tell your doctor about other medications you're taking because they may interact with the methadone.

FDA Patient Safety News: February 2008

For more information, please see our website:
http://www.accessdata.fda.gov/scripts/cdrh/cfdocs/psn/transcript.cfm?show=72#3

Category:

Education

Tags:

• pain
• control
• overdose
• death
• methadone

[playboy2003505]

a freind of mine died a day ago in his sleep! he was taking methadone! and klonopine and benzoz and numerous other drugs his doctor prescribed him!

[sirlovemehard]

Meth is good but also bad... I have been on Meth for 12 years... only did dope for 2. When the Meth built up in my system over a few days, I never had been higher... No amount of dope ever got me as high as I was when I first started taking Meth...... and Meth is WAY harder to get off... because it builds up slower in the body and takes longer to get out of the body... if you have to get onto Meth, avoid going over 60 mgs. You'll be happy when it comes time to get off...

[supervixen404]

i completely agree with you 100%

[travertyler]

Methadone has made my life alot more stabil. Some may take methadone for the rest of their lives, and if it saves them from dope.... so be it.

[badsign1980]

i think the overdoses have to do with pill poppers that think they will get high with methadone and because they dont abuse it and die...methadone dosent get you high!!!never, dosent acululate in such levels in the brain that cause an serotonin release, opiate reaction is extended for longer,...its a pain relief drug but not psicodrug...its perfect for some people...like heroin addicts

[badsign1980]

diamorphine is heroin, pure heroin, and is almost a death setence...lam and metha...is the right answer

[PennyTraition]

As a drug addict,compared to child-abusers, I thought Methadone has been around since the 1940s when in Germany, morphine supplies were cut off. I.G. Farben developed Amidone,or Analgesic #10820,LATER called Dolophine when marketed by Eli Lilly,maybe from the Greek Dolor, ' Pain '? I am wrong , I thought Lex.starting giving hard-line addicts shots in the 50s? My God , Diamorphine is much safer.And a far better analgesic...