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Methadone Brand Names- Dolophine | Methadose
What is Methadone
Methadone is a potent synthetic opiate agonist of the phenylheptylamine class and is structurally unrelated to morphine.
Methadone is a racemic mixture; the l-isomer is responsible for the drug’s analgesic effects. The d-isomer exhibits significantly less analgesic action and lacks respiratory depression activity and addiction liability, but it does have antitussive effects.
Methadone is the most frequently used agent in medically supervised opiate withdrawal and maintenance programs. Federal, state, and local guidelines strictly regulate methadone treatment of opiate dependence.
Effective methadone treatment requires individualized and comprehensive psychosocial support and access to medical and rehabilitative services. Heroin-dependent individuals have better outcomes when they are maintained on methadone than when they are not treated at all, acutely detoxified and released, expelled from treatment programs or when the treatment program is closed.
A study by the National Institute on Drug Abuse (NIDA), the Drug Treatment Outcome Study (DATOS), found that in those patients treated by outpatient methadone centers, weekly heroin use decreased 69%, cocaine use decreased by 48%, illegal activity decreased by 52%, and full time work increased by 24%. There is evidence that methadone treatment is effective in reducing transmission of HIV and hepatitis B and C infections by reducing intravenous drug use and needle sharing.
Indications
- moderate pain
- opiate agonist dependence
- opiate agonist withdrawal
- severe pain
Side Effects
- abdominal pain
- adrenocortical insufficiency
- agitation
- amenorrhea
- anaphylactoid reactions
- anorexia
- anxiety
- apnea
- asthenia
- biliary obstruction
- blurred vision
- bone fractures
- bradycardia
- cardiac arrest
- cardiomyopathy
- confusion
- constipation
- diaphoresis
- dizziness
- drowsiness
- dysphoria
- dyspnea
- edema
- euphoria
- flushing
- glossitis
- gonadal suppression
- hallucinations
- headache
- heart failure
- hyperamylasemia
- hypertension
- hyperthyroidism
- hypokalemia
- hypomagnesemia
- hyponatremia
- hypotension
- hypoventilation
- hypoxia
- impotence (erectile dysfunction)
- infertility
- injection site reaction
- insomnia
- libido decrease
- miosis
- nausea
- neonatal opioid withdrawal syndrome
- oliguria
- orthostatic hypotension
- osteoporosis
- palpitations
- pancreatitis
- peripheral vasodilation
- phlebitis
- physiological dependence
- pruritus
- psychological dependence
- pulmonary edema
- QT prolongation
- rash
- respiratory arrest
- respiratory depression
- restlessness
- seizures
- serotonin syndrome
- SIADH
- sinus tachycardia
- ST-T wave changes
- syncope
- thrombocytopenia
- thrombocytosis
- tolerance
- torsade de pointes
- urinary retention
- urticaria
- ventricular fibrillation
- ventricular tachycardia
- vomiting
- weakness
- weight gain
- withdrawal
- xerostomia
Monitoring Parameters
- laboratory monitoring not necessary
Contraindications
- abrupt discontinuation
- accidental exposure
- adrenal insufficiency
- alcoholism
- angina
- anxiety
- asthma
- biliary tract disease
- bladder obstruction
- bradycardia
- brain tumor
- breast-feeding
- cardiac arrhythmias
- cardiac disease
- chronic obstructive pulmonary disease (COPD)
- CNS depression
- coadministration with other CNS depressants
- coma
- constipation
- cor pulmonale
- coronary artery disease
- dental work
- depression
- diabetes mellitus
- diarrhea
- driving or operating machinery
- females
- geriatric
- GI disease
- GI obstruction
- head trauma
- heart failure
- hepatic disease
- hypertension
- hypocalcemia
- hypokalemia
- hypomagnesemia
- hypotension
- hypothyroidism
- hypovolemia
- hypoxemia
- ileus
- increased intracranial pressure
- infants
- infertility
- inflammatory bowel disease
- intracranial mass
- labor
- long QT syndrome
- malnutrition
- MAOI therapy
- myocardial infarction
- myxedema
- neonatal opioid withdrawal syndrome
- neonates
- obesity
- obstetric delivery
- oliguria
- opiate agonist hypersensitivity
- opioid overdose
- opioid use disorder
- opioid-naive patients
- orthostatic hypotension
- pain
- pancreatitis
- potential for overdose or poisoning
- pregnancy
- prostatic hypertrophy
- pulmonary disease
- QT prolongation
- renal disease
- reproductive risk
- requires an experienced clinician
- respiratory depression
- respiratory insufficiency
- scoliosis
- seizure disorder
- seizures
- sleep apnea
- status asthmaticus
- substance abuse
- surgery
- thyroid disease
- ulcerative colitis
- urethral stricture
- urinary retention
Interactions
- Abacavir
- Abacavir; Dolutegravir; Lamivudine
- Abacavir; Lamivudine, 3TC
- Abacavir; Lamivudine, 3TC; Zidovudine, ZDV
- Abarelix
- Abiraterone
- Acetaminophen; Butalbital
- Acetaminophen; Butalbital; Caffeine
- Acetaminophen; Butalbital; Caffeine; Codeine
- Acetaminophen; Caffeine; Dihydrocodeine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
- Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
- Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
- Acetaminophen; Codeine
- Acetaminophen; Dextromethorphan; Doxylamine
- Acetaminophen; Diphenhydramine
- Acetaminophen; Hydrocodone
- Acetaminophen; Oxycodone
- Acetaminophen; Pentazocine
- Acetaminophen; Propoxyphene
- Acetaminophen; Tramadol
- Acetohydroxamic Acid
- Acidifying Agents
- Acrivastine; Pseudoephedrine
- Aldesleukin, IL-2
- Alfentanil
- Alfuzosin
- Aliskiren; Amlodipine
- Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
- Almotriptan
- Alosetron
- Alprazolam
- Alvimopan
- Amide local anesthetics
- Amifampridine
- Amiloride
- Amiloride; Hydrochlorothiazide, HCTZ
- Amiodarone
- Amitriptyline
- Amitriptyline; Chlordiazepoxide
- Amlodipine
- Amlodipine; Atorvastatin
- Amlodipine; Benazepril
- Amlodipine; Celecoxib
- Amlodipine; Hydrochlorothiazide, HCTZ; Olmesartan
- Amlodipine; Hydrochlorothiazide, HCTZ; Valsartan
- Amlodipine; Olmesartan
- Amlodipine; Telmisartan
- Amlodipine; Valsartan
- Ammonium Chloride
- Amobarbital
- Amoxapine
- Amoxicillin; Clarithromycin; Lansoprazole
- Amoxicillin; Clarithromycin; Omeprazole
- Amphetamine
- Amphetamine; Dextroamphetamine
- Amphetamines
- Amprenavir
- Anagrelide
- Anticholinergics
- Apalutamide
- Apomorphine
- Apraclonidine
- Aprepitant, Fosaprepitant
- Aripiprazole
- Arsenic Trioxide
- Artemether; Lumefantrine
- Articaine; Epinephrine
- Asenapine
- Aspirin, ASA; Butalbital; Caffeine
- Aspirin, ASA; Butalbital; Caffeine; Codeine
- Aspirin, ASA; Caffeine; Dihydrocodeine
- Aspirin, ASA; Caffeine; Orphenadrine
- Aspirin, ASA; Carisoprodol
- Aspirin, ASA; Carisoprodol; Codeine
- Aspirin, ASA; Oxycodone
- Atazanavir
- Atazanavir; Cobicistat
- Atomoxetine
- Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Atropine; Difenoxin
- Atropine; Diphenoxylate
- Atropine; Hyoscyamine; Phenobarbital; Scopolamine
- Azelastine
- Azelastine; Fluticasone
- Azithromycin
- Baclofen
- Barbiturates
- Bedaquiline
- Belladonna Alkaloids; Ergotamine; Phenobarbital
- Belladonna; Opium
- Benzhydrocodone; Acetaminophen
- Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
- Benzphetamine
- Bepridil
- Bethanechol
- Bismuth Subcitrate Potassium; Metronidazole; Tetracycline
- Bismuth Subsalicylate
- Bismuth Subsalicylate; Metronidazole; Tetracycline
- Boceprevir
- Bosentan
- Brexpiprazole
- Brigatinib
- Brimonidine
- Brimonidine; Brinzolamide
- Brimonidine; Timolol
- Brompheniramine
- Brompheniramine; Carbetapentane; Phenylephrine
- Brompheniramine; Dextromethorphan; Guaifenesin
- Brompheniramine; Dextromethorphan; Phenylephrine
- Brompheniramine; Guaifenesin; Hydrocodone
- Brompheniramine; Hydrocodone; Pseudoephedrine
- Brompheniramine; Pseudoephedrine
- Bumetanide
- Bupivacaine
- Bupivacaine Liposomal
- Bupivacaine; Lidocaine
- Buprenorphine
- Buprenorphine; Naloxone
- Bupropion
- Bupropion; Naltrexone
- Buspirone
- Butabarbital
- Butorphanol
- Cannabidiol
- Capecitabine
- Capsaicin; Metaxalone
- Carbamazepine
- Carbetapentane; Chlorpheniramine
- Carbetapentane; Chlorpheniramine; Phenylephrine
- Carbetapentane; Diphenhydramine; Phenylephrine
- Carbetapentane; Guaifenesin
- Carbetapentane; Guaifenesin; Phenylephrine
- Carbetapentane; Phenylephrine
- Carbetapentane; Phenylephrine; Pyrilamine
- Carbetapentane; Pseudoephedrine
- Carbetapentane; Pyrilamine
- Carbinoxamine
- Carbinoxamine; Dextromethorphan; Pseudoephedrine
- Carbinoxamine; Hydrocodone; Phenylephrine
- Carbinoxamine; Hydrocodone; Pseudoephedrine
- Carbinoxamine; Phenylephrine
- Carbinoxamine; Pseudoephedrine
- Carbonic anhydrase inhibitors
- Cariprazine
- Carisoprodol
- Carvedilol
- Celecoxib
- Cenobamate
- Ceritinib
- Cetirizine
- Cetirizine; Pseudoephedrine
- Chlophedianol; Dexbrompheniramine
- Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
- Chloral Hydrate
- Chlorcyclizine
- Chlordiazepoxide
- Chlordiazepoxide; Clidinium
- Chloroquine
- Chlorpheniramine
- Chlorpheniramine; Codeine
- Chlorpheniramine; Dextromethorphan
- Chlorpheniramine; Dextromethorphan; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Phenylephrine
- Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
- Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Hydrocodone
- Chlorpheniramine; Hydrocodone; Phenylephrine
- Chlorpheniramine; Hydrocodone; Pseudoephedrine
- Chlorpheniramine; Phenylephrine
- Chlorpheniramine; Pseudoephedrine
- Chlorpromazine
- Chlorthalidone; Clonidine
- Chlorzoxazone
- Cinacalcet
- Ciprofloxacin
- Cisapride
- Citalopram
- Clarithromycin
- Clemastine
- Clobazam
- Clofazimine
- Clomipramine
- Clonazepam
- Clonidine
- Clopidogrel
- Clorazepate
- Clozapine
- Cobicistat
- Codeine
- Codeine; Guaifenesin
- Codeine; Phenylephrine; Promethazine
- Codeine; Promethazine
- COMT inhibitors
- Conivaptan
- Crizotinib
- Crofelemer
- Cyclizine
- Cyclobenzaprine
- Cyproheptadine
- Dacomitinib
- Dalfopristin; Quinupristin
- Danazol
- Dantrolene
- Darifenacin
- Darunavir
- Darunavir; Cobicistat
- Darunavir; Cobicistat; Emtricitabine; Tenofovir alafenamide
- Dasabuvir; Ombitasvir; Paritaprevir; Ritonavir
- Dasatinib
- Degarelix
- Delavirdine
- Desflurane
- Desipramine
- Desmopressin
- Deutetrabenazine
- Dexchlorpheniramine
- Dexchlorpheniramine; Dextromethorphan; Pseudoephedrine
- Dexmedetomidine
- Dexpanthenol
- Dextroamphetamine
- Dextromethorphan; Diphenhydramine; Phenylephrine
- Dextromethorphan; Promethazine
- Dextromethorphan; Quinidine
- Diazepam
- Didanosine, ddI
- Dihydrocodeine; Guaifenesin; Pseudoephedrine
- Diltiazem
- Dimenhydrinate
- Diphenhydramine
- Diphenhydramine; Hydrocodone; Phenylephrine
- Diphenhydramine; Ibuprofen
- Diphenhydramine; Naproxen
- Diphenhydramine; Phenylephrine
- Disopyramide
- Dofetilide
- Dolasetron
- Dolutegravir; Rilpivirine
- Donepezil
- Donepezil; Memantine
- Doxepin
- Doxylamine
- Doxylamine; Pyridoxine
- Dronabinol
- Dronedarone
- Droperidol
- Efavirenz
- Efavirenz; Emtricitabine; Tenofovir
- Efavirenz; Lamivudine; Tenofovir Disoproxil Fumarate
- Elagolix
- Elagolix; Estradiol; Norethindrone acetate
- Eletriptan
- Elexacaftor; tezacaftor; ivacaftor
- Eliglustat
- Eltrombopag
- Eluxadoline
- Elvitegravir
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Alafenamide
- Elvitegravir; Cobicistat; Emtricitabine; Tenofovir Disoproxil Fumarate
- Emtricitabine; Rilpivirine; Tenofovir alafenamide
- Emtricitabine; Rilpivirine; Tenofovir disoproxil fumarate
- Encorafenib
- Enflurane
- Entrectinib
- Enzalutamide
- Eribulin
- Erythromycin
- Erythromycin; Sulfisoxazole
- Escitalopram
- Esketamine
- Estazolam
- Eszopiclone
- Ethacrynic Acid
- Ethanol
- Ethotoin
- Etomidate
- Etravirine
- Everolimus
- Ezogabine
- Fedratinib
- Fenfluramine
- Fenofibric Acid
- Fentanyl
- Fesoterodine
- Fingolimod
- Flecainide
- Flibanserin
- Fluconazole
- Fludrocortisone
- Fluoxetine
- Fluoxetine; Olanzapine
- Fluphenazine
- Flurazepam
- Fluvoxamine
- Fosamprenavir
- Foscarnet
- Fosphenytoin
- Fospropofol
- Fostamatinib
- Frovatriptan
- Furosemide
- Gabapentin
- Gemifloxacin
- Gemtuzumab Ozogamicin
- Gilteritinib
- Givosiran
- Glasdegib
- Goserelin
- Granisetron
- grapefruit juice
- Guaifenesin; Hydrocodone
- Guaifenesin; Hydrocodone; Pseudoephedrine
- Guanabenz
- Guanfacine
- Guselkumab
- Halofantrine
- Haloperidol
- Halothane
- Histrelin
- Homatropine; Hydrocodone
- Hydantoins
- Hydrochlorothiazide, HCTZ; Methyldopa
- Hydrochlorothiazide, HCTZ; Spironolactone
- Hydrochlorothiazide, HCTZ; Triamterene
- Hydrocodone
- Hydrocodone; Ibuprofen
- Hydrocodone; Phenylephrine
- Hydrocodone; Potassium Guaiacolsulfonate
- Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
- Hydrocodone; Pseudoephedrine
- Hydromorphone
- Hydroxychloroquine
- Hydroxyprogesterone
- Hydroxyzine
- Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
- Ibritumomab Tiuxetan
- Ibuprofen; Oxycodone
- Ibutilide
- Idelalisib
- Iloperidone
- Imatinib
- Imipramine
- Indinavir
- Inotuzumab Ozogamicin
- Isavuconazonium
- Isocarboxazid
- Isoflurane
- Isoniazid, INH; Pyrazinamide, PZA; Rifampin
- Isoniazid, INH; Rifampin
- Istradefylline
- Itraconazole
- Ivacaftor
- Ivosidenib
- Ixabepilone
- Ketamine
- Ketoconazole
- Lamivudine, 3TC; Zidovudine, ZDV
- Lapatinib
- Larotrectinib
- Lasmiditan
- Ledipasvir; Sofosbuvir
- Lefamulin
- Lemborexant
- Lenvatinib
- Letermovir
- Leuprolide
- Leuprolide; Norethindrone
- Levobupivacaine
- Levocetirizine
- Levofloxacin
- Levomilnacipran
- Levorphanol
- Lidocaine
- Lidocaine; Prilocaine
- Lincosamides
- Linezolid
- Lisdexamfetamine
- Lithium
- Lofexidine
- Lomefloxacin
- Long-acting beta-agonists
- Loop diuretics
- Loperamide
- Loperamide; Simethicone
- Lopinavir; Ritonavir
- Lorazepam
- Lorlatinib
- Loxapine
- Lubiprostone
- Luliconazole
- Lumacaftor; Ivacaftor
- Lumacaftor; Ivacaftor
- Lumateperone
- Lurasidone
- Macimorelin
- Magnesium Salts
- Maprotiline
- Meclizine
- Mefloquine
- Melatonin
- Meperidine
- Meperidine; Promethazine
- Mephobarbital
- Mepivacaine
- Mepivacaine; Levonordefrin
- Meprobamate
- Metaxalone
- Methamphetamine
- Methenamine; Sodium Acid Phosphate
- Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
- Methocarbamol
- Methohexital
- Methyldopa
- Methylene Blue
- Methylphenidate
- Metoclopramide
- Metronidazole
- Metyrapone
- Metyrosine
- Midazolam
- Midostaurin
- Mifepristone
- Milnacipran
- Minocycline
- Mirabegron
- Mirtazapine
- Mitotane
- Molindone
- Morphine
- Morphine; Naltrexone
- Moxifloxacin
- Nabilone
- Nalbuphine
- Naloxone
- Naltrexone
- Naproxen; Sumatriptan
- Naratriptan
- Nefazodone
- Nelfinavir
- Nesiritide, BNP
- Nevirapine
- Nicardipine
- Nilotinib
- Nitisinone
- Nitroglycerin
- Norfloxacin
- Nortriptyline
- Octreotide
- Ofloxacin
- Olanzapine
- Ombitasvir; Paritaprevir; Ritonavir
- Omeprazole; Amoxicillin; Rifabutin
- Ondansetron
- Oritavancin
- Orphenadrine
- Osilodrostat
- Osimertinib
- Oxaliplatin
- Oxazepam
- Oxycodone
- Oxymorphone
- Ozanimod
- Palbociclib
- Paliperidone
- Panobinostat
- Papaverine
- Paroxetine
- Pasireotide
- Pazopanib
- Peginterferon Alfa-2a
- Peginterferon Alfa-2b
- Pegvisomant
- Pentamidine
- Pentazocine
- Pentazocine; Naloxone
- Pentobarbital
- Perampanel
- Perindopril; Amlodipine
- Perphenazine
- Perphenazine; Amitriptyline
- Phenelzine
- Phenobarbital
- Phenylephrine; Promethazine
- Phenytoin
- Pimavanserin
- Pimozide
- Pitolisant
- Posaconazole
- Potassium Phosphate; Sodium Phosphate
- Potassium-sparing diuretics
- Pramipexole
- Pramlintide
- Prasugrel
- Pregabalin
- Prilocaine
- Prilocaine; Epinephrine
- Primaquine
- Primidone
- Procainamide
- Procarbazine
- Prochlorperazine
- Promethazine
- Propafenone
- Propofol
- Propoxyphene
- Protriptyline
- Quazepam
- Quetiapine
- Quinidine
- Quinine
- Ramelteon
- Ranolazine
- Rasagiline
- Remifentanil
- Ribociclib
- Ribociclib; Letrozole
- Rifabutin
- Rifampin
- Rifapentine
- Rilpivirine
- Risperidone
- Ritonavir
- Rizatriptan
- Rolapitant
- Romidepsin
- Ropinirole
- Ropivacaine
- Rotigotine
- Rucaparib
- Safinamide
- Sapropterin
- Saquinavir
- Secobarbital
- Selegiline
- Selpercatinib
- Serotonin-Receptor Agonists
- Sertraline
- Sevoflurane
- Short-acting beta-agonists
- Sibutramine
- Sildenafil
- Simeprevir
- Siponimod
- Sodium Benzoate; Sodium Phenylacetate
- Sodium Oxybate
- Sodium Phosphate Monobasic Monohydrate; Sodium Phosphate Dibasic Anhydrous
- Solifenacin
- Sorafenib
- Sotalol
- Sparfloxacin
- Spironolactone
- St. John’s Wort, Hypericum perforatum
- Stavudine, d4T
- Streptogramins
- Sufentanil
- Sumatriptan
- Sunitinib
- Suvorexant
- Tacrolimus
- Tamoxifen
- Tapentadol
- Tasimelteon
- Tazemetostat
- Tedizolid
- Telaprevir
- Telavancin
- Telithromycin
- Telotristat Ethyl
- Temazepam
- Terbinafine
- Tetrabenazine
- Tezacaftor; Ivacaftor
- Thalidomide
- Thiazide diuretics
- Thiopental
- Thioridazine
- Thiotepa
- Thiothixene
- Ticagrelor
- Tipranavir
- Tizanidine
- Tolterodine
- Toremifene
- Torsemide
- Tramadol
- Trandolapril; Verapamil
- Tranylcypromine
- Trazodone
- Triamterene
- Triazolam
- Triclabendazole
- Tricyclic antidepressants
- Trifluoperazine
- Trimethobenzamide
- Trimipramine
- Triprolidine
- Triptorelin
- Trospium
- Tucatinib
- Valerian, Valeriana officinalis
- Valproic Acid, Divalproex Sodium
- Vandetanib
- Vardenafil
- Vemurafenib
- Venlafaxine
- Verapamil
- Vigabatrin
- Vilazodone
- Vincristine Liposomal
- Voriconazole
- Vorinostat
- Vortioxetine
- Voxelotor
- Zafirlukast
- Zaleplon
- Ziconotide
- Zidovudine, ZDV
- Ziprasidone
- Zolmitriptan
- Zolpidem
- Zonisamide
