Substances Authority for information on how to prevent and detect abuse or diversion of this product. Interactions with other CNS Depressants. Medscape – Detoxification, pain-specific dosing for Methadose, Dolophine opioids; Substantial interpatient variability, see prescribing information for guidance. Find patient medical information for Dolophine Oral on WebMD including its uses , side effects and safety, interactions, pictures, warnings and user ratings.
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If an opioid must be used, consider reducing use of other CNS-active medications that increase the risk of falls and fractures and implement other strategies to reduce fall risk. For the maintenance treatment of opiate agonist dependence. Respiratory depression, if left untreated, may cause respiratory arrest and death.
Maintenance should be continued as long as desired by the patient and as long as continued benefit is derived from treatment.
Neonates and infants younger than 6 months of age have highly variable clearance of opiate agonists. Outpatient maintenance and outpatient detoxification treatment may be provided only by Opioid Treatment Programs OTPs certified by the U. Conservative dose selection is recommended for opioid-tolerant patients due to dose conversion ratio uncertainty and incomplete cross-tolerance.
Dosage, interval, length of treatment, and taper schedule must be individualized based on patient’s previous opioid dose and symptoms of withdrawal. Monitor patients closely for respiratory depression, especially during the first 24 to 72 hours after initiation or dosage increase. Consider the benefits of breast-feeding along with the mother’s clinical need for methadone and any potential adverse effects on the breast-fed child from methadone or the underlying maternal condition.
Methadone hydrochloride Injection may be administered intravenously, subcutaneously, or intramuscularly.
There is considerable individual variation in the rate of taper tolerated. If the opioid can be discontinued, a follow-up assessment of adrenal function should be performed to determine if corticosteroid treatment can be discontinued. Symptoms of respiratory depression include a reduced urge to breathe, a decreased respiratory rate, or deep breaths separated by long pauses a “sighing” breathing pattern.
Patients with CNS depression, head trauma, intracranial mass, brain tumor, or increased intracranial pressure should be given methadone with extreme caution. Use methadone with caution in patients with cardiac disease or other conditions that may increase the risk of QT prolongation including heart failure, bradycardia, dolphine infarction, hypertension, coronary artery disease, hypocalcemia, or in patients receiving medications known to cause electrolyte imbalances.
Methadone should be avoided in patients treated with monoamine oxidase inhibitor therapy MAOI therapydue to the potential risk for serotonin syndrome.
Consider these risks in pregnant women treated with methadone for maintenance treatment of opioid addiction. Discontinue all other dolopphine opioid drugs upon initiation of methadone.
Safety and efficacy in pediatric patients have not been established; however, methadone is used off-label in these populations. Stir well and have patient drink all of the dosage dispersed. The clinical significance of these effects during methadone therapy specifically is not known. Dosage adjustments on subsequent days should be based on withdrawal symptom control at informayion time of expected peak methadone activity 2 to 4 hours after dosing.
If concurrent use is necessary, use the lowest effective doses and minimum treatment durations possible and monitor patients closely for signs and symptoms of respiratory depression and sedation. Start these patients on lower doses and titrate slowly while carefully monitoring for signs of perscribing and CNS depression. Of particular concern are respiratory and presxribing related complications, informtaion death, which may occur during treatment with the informatipn.
Chronic opioid use may influence the hypothalamic-pituitary-gonadal axis, leading to hormonal infomration that may manifest as hypogonadism gonadal suppression and pose a reproductive risk.
Serious or fatal respiratory depression can occur at any time during the use of methadone; however, the risk is greatest during the first 24 to 72 hours after therapy initiation or dose titration. In patients with pulmonary disease such as chronic obstructive pulmonary disease COPDcor pulmonale, decreased respiratory reserve, hypoxia, hypercapnia, respiratory insufficiency, upper airway obstruction, or preexisting respiratory depression, it is recommended that non-opioid analgesics be considered as alternatives to methadone, as even usual therapeutic doses may decrease respiratory drive and cause apnea in these patient populations.
Accidental exposure, opioid-naive patients, potential for overdose or poisoning. Health care professionals should not confuse such symptoms with those of opiate abstinence and should not treat anxiety by increasing the dosage of methadone.
If patients experience breakthrough pain, dose adjustment or a small rescue dose of an immediate-release analgesic should be considered. Morphine is well recognized to increase the tone of the biliary tract causing spasms predcribing in the sphincter of Oddi increasing biliary tract pressure.
An understanding of methadone pharmacokinetic parameters is critical. Methadone has not been extensively evaluated in patients with renal insufficiency.
Avoid use of partial agonists e. Opioids inhibit the secretion of adrenocorticotropic hormone Prescribjngcortisol, and luteinizing hormone LH ; however, the thyroid stimulating hormone may be either stimulated or inhibited by opioids.
Methadone Dolophine, Methadose – Treatment – Hepatitis C Online
Deaths have occurred in early treatment due to the cumulative effects of methadone. Patients with cancer-related pain may have decreased clearance of methadone as compared to patients with chronic, benign pain. Methadone is not a drug of choice for pain management in opiate-naive pediatric patients, but off-label use of methadone has been described for children and adolescents who are opiate-experienced. The growth deficit does not appear to persist into later childhood.
Detoxification shall not exceed 21 days or be repeated earlier than 4 weeks after completion of a preceding course. Advise breast-feeding women taking methadone to monitor the infant for increased drowsiness and breathing difficulty. There is considerable individual variation in the rate of taper when discontinuing methadone. Discontinue methadone and other serotonergic agents if serotonin syndrome is suspected and institute appropriate medical treatment.
Monitor patients for hypotension at the initiation of therapy and during dose titration. When the patient no longer requires methadone, taper the dose gradually every 2 to 4 days to prevent withdrawal in the physically-dependent patient.
Initial doses may need to be reduced, and doses should be carefully titrated taking into account analgesic effects, adverse reactions, and informatiob drugs that may depress respiration. This syndrome can be life-threatening. Withdrawal of methadone following detoxification treatment.