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Methadone is used as a pain reliever and as part of drug addiction detoxification and maintenance programs and is only available from certified pharmacies.Methadone is an opioid medication. An opioid is sometimes called a narcotic. Methadone reduces withdrawal symptoms in people addicted to heroin or other narcotic drugs without causing the "high" associated with the drug addiction.
Important information
You should not use methadone if you have severe asthma or breathing problems, or a bowel obstruction called paralytic ileus.
Methadone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use this medicine in larger amounts, or for longer than prescribed. This medicine may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
Methadone is available only from a certified pharmacy.Methadone may cause a life-threatening heart rhythm disorder. Call your doctor at once if you have a headache with chest pain and severe dizziness, and fast or pounding heartbeats.
Before using methadone
You should not use methadone if you are allergic to it, or if you have:
Methadone may cause a life-threatening heart rhythm disorder. Your heart function may need to be checked during treatment.
To make sure this medicine is safe for you, tell your doctor if you have:
heart disease, or heart rhythm disorder;
personal or family history of long QT syndrome;
an electrolyte imbalance (such as low levels of potassium or magnesium in your blood);
any type of breathing problem or lung disease;
a history of head injury, brain tumor, or seizures;
a history of drug abuse, alcohol addiction, or mental illness;
urination problems;
liver or kidney disease;
problems with your gallbladder, pancreas, or thyroid.
Methadone is more likely to cause breathing problems in older adults and people who are severely ill, malnourished, or otherwise debilitated.
FDA pregnancy category C. It is not known whether methadone will harm an unborn baby.Methadone may cause breathing problems, behavior changes, or addiction and withdrawal symptoms in your newborn if you use the medication during pregnancy. Tell your doctor if you are pregnant.
Methadone can pass into breast milk and may cause breathing problems or addiction and withdrawal symptoms in a nursing baby. Tell your doctor if you are breast-feeding a baby.
How should I use methadone?
Methadone may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICATION CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away methadone is against the law.
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Follow all directions on your prescription label. Methadone can slow or stop your breathing, especially when you start using this medicine or whenever your dose is changed. Never use in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Measure liquid medicine with the dosing syringe provided, or with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Dissolve the dispersible tablet in at least 4 ounces of water, orange juice, or other citrus-flavored non-alcoholic beverage. Allow the tablet to disperse in the liquid. The tablet will not dissolve completely. Drink this mixture right away. To get the entire dose, add a little more water to the same glass, swirl gently and drink right away.
Never use methadone tablets or liquid to make a mixture for injecting the drug into your vein. This practice has resulted in death with the misuse of methadone and similar prescription drugs.
When used as part of a treatment program for drug addiction or detoxification, your doctor may recommend that each dose be given to you by a family member or other caregiver. This is to make sure you are using the medicine as it was prescribed as part of your treatment.
Additional forms of counseling and/or monitoring may be recommended during treatment with methadone.
You should not stop using this medicine suddenly. Follow your doctor's instructions about tapering your dose.
Store at room temperature away from moisture and heat. Keep the medication in a place where others cannot get to it.
Keep track of how much of this medicine has been used. Methadone is a drug of abuse and you should be aware if any person in the household is using this medicine improperly or without a prescription.
After you have stopped using this medication, flush any unused pills down the toilet. Disposal of medicines by flushing is recommended to reduce the danger of accidental overdose causing death. This advice applies to a very small number of medicines only. The FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal and presents the least risk to human safety.
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| Methadone Molecule |
What happens if I miss a dose?
If you take methadone for pain: Take the missed dose as soon as you remember, then take your next dose 8 to 12 hours later. Skip the missed dose if it is almost time for your next scheduled dose.
If you take methadone for drug addiction: Take your missed dose the next day at the regular time. If you miss your doses for longer than 3 days in a row, call your doctor for instructions. You may need to restart at a lower dose.
Do not use extra medicine to make up a missed dose.
What happens if I overdose?
Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A methadone overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.
What should I avoid?
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with methadone. Check your food and medicine labels to be sure these products do not contain alcohol.
Methadone may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Grapefruit and grapefruit juice may interact with methadone and lead to unwanted side effects. Discuss the use of grapefruit products with your doctor.
SIDE EFFECTS
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| Methadone Saves Life..! |
Get emergency medical help if you have any of these signs of an allergic reaction to methadone: hives; difficult breathing; swelling of your face, lips, tongue, or throat.
Even if you have used other narcotic medications, you may still have serious side effects from methadone.
Call your doctor at once if you have:
weak or shallow breathing;
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a light-headed feeling, like you might pass out; or
symptoms of a life-threatening heart rhythm disorder--a headache with chest pain and severe dizziness, and fast or pounding heartbeats.
Common methadone side effects may include:
dizziness, drowsiness;
nausea, vomiting; or
increased sweating.
This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.
Along with its needed effects, methadone may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking methadone:
ncidence not known
- Black, tarry stools
- bleeding gums
- blood in the urine or stools
- blurred vision
- bulging soft spot on the head of an infant
- change in the ability to see colors, especially blue or yellow
- changes in skin color
- chest discomfort or pain
- confusion
- convulsions
- cough
- coughing that sometimes produces a pink frothy sputum
- decreased urine output
- difficult or troubled breathing
- difficult, fast, noisy breathing, sometimes with wheezing
- difficulty swallowing
- dilated neck veins
- dizziness
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- dry mouth
- extreme fatigue
- fainting
- fast, slow, or irregular heartbeat
- headache
- hives
- increased sweating
- increased thirst
- irregular heartbeat recurrent
- irregular, fast or slow, or shallow breathing
- itching
- loss of appetite
- muscle pain or cramps
- nausea or vomiting
- numbness or tingling in the hands, feet, or lips
- pain
- pale or blue lips, fingernails, or skin
- pinpoint red spots on the skin
- puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue
- seizures
- skin rash
- sweating
- swelling of the face, fingers, feet, or lower legs
- tenderness
- trouble in urinating
- trouble sleeping
- unusual bleeding or bruising
- unusual tiredness or weakness
- weight gain
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| Liquid Methadone |
Some side effects of methadone may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Incidence not known
- Absent, missed, or irregular menstrual periods
- anxiety
- blurred or loss of vision
- confusion about identity, place, and time
- constipation
- decreased interest in sexual intercourse
- disturbed color perception
- double vision
- false or unusual sense of well-being
- halos around lights
- inability to have or keep an erection
- irritability
- lack or loss of strength
- loss in sexual ability, desire, drive, or performance
- night blindness
- overbright appearance of lights
- redness, swelling, or soreness of the tongue
- restlessness
- stopping of menstrual bleeding
- tunnel vision
- weight changes
- welts
Nervous system
Other neurologic side effects are rare, but include tardive dyskinesia and choreic movements.
Nervous system side effects have included agitation, confusion, disorientation, dysphoria, euphoria, seizures, sleepiness or insomnia, and dizziness.
Cardiovascular
Cardiovascular side effects have included hypotension, bradycardia, arrhythmias, bigeminal rhythms, cardiomyopathy, ECG abnormalities, extrasystoles, flushing, heart failure, palpitations, phlebitis, QT interval prolongation, syncope, T-wave inversion, tachycardia, torsade de pointes, ventricular fibrillation, ventricular tachycardia and edema. Rare cases of cardiac arrest have also been reported.
Gastrointestinal
Methadone may cause contraction of the sphincter of Oddi, which may increase intrabiliary pressure and worsen, rather than relieve, biliary colic.
Gastrointestinal side effects have included constipation, abdominal pain, biliary tract spasm, dry mouth, glossitis, and appetite abnormalities.
Other
Other side effects have included increased sweating which has been common after chronic methadone use.
Hypersensitivity
Hypersensitivity side effects to methadone are rare, and have included rash, pruritus, and edema.
Psychiatric
One study has suggested that detoxification from methadone maintenance therapy may result in the development of an organic mood syndrome in many patients.
Psychiatric side effects have included psychological dependence. A case of obsessive compulsive symptoms precipitated by methadone tapering has been reported.
Endocrine
Endocrine side effects have included stimulation of thyroxine binding globulin (TBG), resulting in increased TBG, total T3 and T4, but unaltered free T3 and T4. Hyperprolactinemia has also been associated with methadone therapy.
Genitourinary
Genitourinary side effects have included amenorrhea, antidiuretic effect, reduced libido and/or potency, urinary hesitancy, and urinary retention.
Respiratory
Respiratory side effects have included pulmonary edema, respiratory depression, and a blunted response to hypercarbia.
Renal
A case of rhabdomyolysis and subsequent acute renal failure following ingestion of large doses of methadone has been reported.
Hematologic
Hematologic side effects associated with methadone have included mild lymphocytosis and increased serum protein, albumin, and globulin.
General
General side effects including asthenia, edema, and headache have been reported.
Metabolic
Metabolic side effects including hypokalemia, hypomagnesemia, and weight gain have been reported.
Ocular
Ocular side effects have included visual disturbances.
What other drugs will affect methadone?
Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking methadone with a sleeping pill, narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.
Many drugs can interact with methadone. Tell your doctor about all your medications and any you start or stop using during treatment with this medicine. This includes prescription and over-the-counter medicines, vitamins, and herbal products. Give a list of all your medicines to any healthcare provider who treats you.
Jogja, Oktober 2008
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