High Alert
Absorption: 50% absorbed following oral administration. IV administration results in complete bioavailability.
Distribution: Widely distributed to tissues.
Protein Binding: 8590%.
Half-Life: 1525 hr (↑ with chronic use).
(analgesic effect)
ROUTE | ONSET | PEAK | DURATION |
---|---|---|---|
PO | 3060 min | 90120 min | 412 hr |
IM, IV, SUBQ | 1020 min | 60120 min | 812 hr |
Contraindicated in:
Use Cautiously in:
CV: hypotension, bradycardia, QT interval prolongation, TORSADES DE POINTES
Derm: flushing, sweating
EENT: blurred vision, diplopia, miosis
Endo: adrenal insufficiency
GI: constipation, nausea, vomiting
Neuro: confusion, sedation, dizziness, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams
Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)
Misc: allodynia, opioid-induced hyperalgesia, physical dependence, psychological dependence, tolerance
Drug-drug:
Drug-Natural Products:
Moderate to Severe Pain
Opioid Detoxification
Lab Test Considerations:
Toxicity and Overdose:
Do not confuse methadone with dexmethylphenidate, ketorolac, memantine, methylphenidate, or metolazone.
FDA strongly encourages health care professionals to complete a REMS-compliant education program that includes all the elements of the FDA Education Blueprint for Health Care Providers Involved in the Management or Support of Patients with Pain, available at www.fda.gov/OpioidAnalgesicREMSBlueprint. Information on programs can be found at 1-800-503-0784 or www.opioidanalgesicrems.com.
IV Administration:
Instruct patient to take methadone exactly as directed. If dose is less effective after a few wk, do not ↑ dose without consulting health care professional. Discuss safe use, risks, and proper storage and disposal of opioid analgesics with patients and caregivers with each Rx. The Patient Counseling Guide is available at www.fda.gov/OpioidAnalgesicREMSPCG.
NDC Code