Methadone is an opioid medication. It's used to treat adults with long-term pain that's not relieved by non-opioid pain medications. Methadone is also used with counseling and support programs for opioid use disorder (or opioid addiction). When it's used for opioid use disorder, it's first given at a methadone clinic under the supervision of a healthcare professional (HCP). Methadone is available as tablets, liquids, and dissolvable tablets that are taken by mouth. It's common to have side effects like lightheadedness, dizziness, and sleepiness.
Long-term pain that isn't relieved by non-opioid pain medications alone - except for Methadose brand name and its generics)
Treatment and maintenance of opioid use disorder (OUD) - all brand names and generics
Methadone is an opioid. It attaches to certain mu-opioid receptors in your brain to lower how much pain you feel.
Methadone can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Personal or family history of alcohol or substance use disorder | Personal or family history of mental health conditions | History of taking an opioid for a long period of time
Methadone is a controlled substance that has a risk for misuse and addiction. Take the medication exactly as prescribed. Don't change how much or how often you take it without talking to your prescriber first.
Misusing methadone can raise the risk for serious and possibly life-threatening side effects, such as dangerously slow breathing, not being able to stay awake, addiction, and opioid overdose. You'll be prescribed the lowest amount of methadone that's necessary to manage your condition for the shortest period of time possible.
Because of the risk for misuse and addiction, methadone for the treatment of pain is only available through a Risk Evaluation and Mitigation Strategy (REMS) program called the Opioid Analgesic REMS program. Your prescriber and pharmacy must register with the program, receive training on proper medication use, and discuss with you about how to take methadone safely.
Risk factors: Taking medications that can cause slow breathing | Drinking alcohol | Older age | Being frail | Medical conditions that cause breathing problems (e.g., COPD, asthma, head injury) | Taking too much methadone
Methadone can cause dangerously slow breathing, which can be life-threatening. This can happen to anyone and at recommended doses. But the risk is greatest when you first start treatment or when your dose goes up.
Don't drink alcohol while you're taking methadone. And don't take methadone with other medications that slow your body down (e.g., benzodiazepines, other opioids, muscle relaxants). Otherwise, you're at very high risk for extremely slowed breathing.
Your prescriber will recommend that you also have a medication called naloxone (Narcan) — either by prescription or over the counter — to carry with you at all times. Naloxone helps reverse slow breathing from opioids. Use naloxone, call 911, and get help right away if you or your loved one notices that you have trouble breathing or have bluish-colored lips, fingers, or toes.
Risk factors: History of opioid use disorder | Previous opioid overdose | Taking high doses of methadone | Taking more opioids than prescribed | Alcohol use
Take methadone exactly as prescribed. Taking too much medication or taking it more often than prescribed can lead to an overdose. It can be very dangerous if someone accidentally swallows the medication. Be sure to keep the medication out of reach from children, pets, or visitors to prevent accidental exposure or overdose.
Symptoms of an opioid overdose include not responding to sound or touch, extremely slow breathing, slow heartbeat, extreme sleepiness, and cold or clammy skin. Be sure you and your loved ones know how to recognize an overdose. Your prescriber will recommend getting naloxone (Narcan) — either by prescription or over the counter. Naloxone is a medication that can treat an opioid overdose. Carry naloxone with you at all times; use it and call 911 right away if an overdose happens.
Risk factors: Taking high doses of methadone | Age 65 years or older | Drinking alcohol | Taking other medications that can cause sleepiness
Methadone can cause extreme sleepiness and lower your ability to think, react, and focus. Don't drink alcohol or take other medications that can cause sleepiness or "brain fog" (e.g., benzodiazepines, muscle relaxants, sleep medications) with methadone. Otherwise, it can worsen these side effects.
Make sure you know how methadone affects you before driving a car or doing activities that require your concentration. Talk to your prescriber if you feel too sleepy from the medication.
Risk factors: High methadone dose | Heartbeat or heart rhythm problems | Heart failure | Electrolyte levels that aren't balanced in the body | Taking other medications that cause QT prolongation
It's possible for methadone to lengthen the time it takes for your heart to relax and contract. This is called QT prolongation and it can sometimes lead to a potentially life-threatening heart rhythm problem. Tell your prescriber about your full medical history and all the medications you take before you start methadone. Contact a healthcare professional (HCP) if you feel symptoms of a heart rhythm problem, such as pounding chest, trouble breathing, feeling faint or lightheaded, or chest pain, while you're taking methadone.
Methadone interacts with many medications. So it's important to tell your prescriber and pharmacist about the medications you're taking and planning to take with methadone. Your care team can check that your medications are safe to take together. Also speak with your care team first before making any changes to your medications because sudden dose adjustments can also lead to harm.
Some interactions can raise the level of methadone in your body. This can raise your risk for serious side effects, including potentially life-threatening slow breathing. Some medications that can lead to this type of interaction with methadone include erythromycin, ketoconazole, and sertraline (Zoloft).
Other drug interactions can lower the levels of methadone in your body. This can cause the opioid medication to work less well or possibly lead to opioid withdrawal symptoms. These interactions include taking methadone with rifampin (Rifadin) or carbamazepine (Tegretol).
Long-term use of methadone during pregnancy can cause your unborn baby to become dependent on the medication. This is because methadone can pass through the placenta to your unborn baby.
Once your baby is born, they can experience withdrawal symptoms, such as high-pitched crying, poor feeding behavior, trembling, abnormal sleep patterns, and even seizures. This condition is called neonatal opioid withdrawal syndrome and can be life-threatening if not recognized and treated in time. Let your HCP know if you've taken methadone during pregnancy or if you notice these symptoms in your baby.
Risk factors: Taking a monoamine oxidase inhibitor (MAOI) 14 days before starting methadone | Taking other medications that raise serotonin levels in your brain
Some people have reported developing serotonin syndrome when they took methadone with other medications that affect serotonin levels, like certain antidepressants, MAOIs, linezolid (Zyvox), and migraine medications. Serotonin syndrome is a rare, but potentially life-threatening condition that happens when there's too much serotonin in the brain. Get medical help right away if you have any symptoms of serotonin syndrome, including fast heart rate, muscle stiffness or spasms, high fever, and confusion.
Methadone can cause extremely low blood pressure. In addition, your blood pressure might drop when you stand from a sitting or lying down position. Having low blood pressure can lead to dizziness and fainting. To avoid falling, get up slowly if you've been sitting or lying down. Talk to your HCP if any dizziness or lightheadedness doesn't go away.
Risk factors: Taking methadone for longer than 1 month
Some people taking opioid medications like methadone have had low adrenal hormone levels. This might be more likely to happen after taking opioids for longer than 1 month. Tell your HCP if you have any symptoms of low adrenal hormone levels, like tiredness, dizziness, weakness, not feeling hungry, nausea, and vomiting. If your adrenal hormone levels are too low, you might need to stop methadone and get treated with corticosteroids.
Risk factors: History of seizure conditions
Opioids like methadone can raise the risk of having seizures more often in people who've had one before. Methadone can also raise your risk of seizures in certain situations. Get medical help right away if you have a seizure while you're taking this medication.
Risk factors: History of diabetes
Although rare, some people with diabetes who took methadone reported having episodes of low blood sugar levels (hypoglycemia). Sometimes, blood sugar levels were low enough that it required hospitalization. Check your blood sugar if you feel symptoms of hypoglycemia, such as fast heartbeat, shakiness, anxiety, sweating, weakness, or confusion. Treat your low blood sugar right away.
Risk factors: Long-term use of methadone
Don't suddenly lower your dose or stop taking methadone without talking to your prescriber if you're physically dependent on opioids. Being physically dependent means that your body relies on opioids to function normally.
Lowering your dose or stopping methadone too fast can cause your pain to come back. It can also lead to bothersome withdrawal symptoms, including anxiety, restlessness, irritability, runny nose, sweating, and chills. If needed, your prescriber will slowly lower your methadone dose over time to prevent withdrawal symptoms.
Source: DailyMed
Along with its needed effects, a medicine 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:
Incidence 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
coughing that sometimes produces a pink frothy sputum
decreased urine output
difficult or troubled breathing
difficult, fast, noisy breathing, sometimes with wheezing
difficulty with swallowing
dilated neck veins
dizziness
dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
extreme fatigue
fainting
fast, slow, or irregular heartbeat
headache
increased sweating
increased thirst
irregular heartbeat
irregular, fast or slow, or shallow breathing
loss of appetite
muscle pain or cramps
nausea or vomiting
numbness or tingling in the hands, feet, or lips
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
sweating
swelling of the face, fingers, feet, or lower legs
tenderness
trouble sleeping
trouble urinating
unusual bleeding or bruising
unusual tiredness or weakness
Some side effects 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
blurred or loss of vision
confusion about identity, place, and time
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
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
Comes as a tablet and liquid that are taken by mouth
Available as a lower-cost generic version
Can cause life-threatening slow breathing, especially if it's mixed with alcohol
Has potential to be habit-forming
Constipation is a common side effect of opioids like methadone. To help manage constipation, drink plenty of water and add more foods with fiber to your meals. Speak to your care team about your options if it doesn't seem to improve with these lifestyle changes.
Don't drink alcohol while you're taking methadone. Otherwise, you might get very sleepy or dizzy and you might not be able to think clearly, which can lead to accidental injuries.
Take methadone exactly as your prescriber instructed you to. Don't lower your dose or stop taking it without talking to your prescriber first. Your prescriber will give you specific instructions to follow to lower your dose slowly over time. This lowers your risk for withdrawal symptoms like muscle aches, chills, and trouble sleeping.
It's recommended that you always have naloxone (Narcan) with you. Naloxone is a medication that can help reverse the effects of methadone in situations like an accidental overdose. Be sure your loved ones know how to give naloxone to you if you can't do it yourself. Call 911 right away if you need to use naloxone because its effects are temporary.
Let your prescriber know if you're pregnant or breastfeeding. Your prescriber will weigh the risks and benefits of taking methadone. In general, opioids aren't recommended for pain while pregnant or breastfeeding because they can raise the risk for serious harm to the baby.
Keep methadone out of reach from children, pets, or visitors. Ask your prescriber or pharmacist about drug take-back options to safely get rid of the medication if you don't need it anymore. This lessens the risk for accidental overdose and medication misuse.
Tips for the methadone liquid:
Methadone liquid comes in different strengths: 1 mg/mL, 2 mg/mL, and 10 mg/mL. Make sure you know which strength of the liquid you have and how to properly measure your dose to avoid potentially taking the wrong dose. Ask your prescriber if you're not sure.
For the dissolvable tablets for oral suspension, only prepare the dose when you're ready to take it. Place the tablet in 120 mL (about one-half cup) of water, orange juice, or other acidic fruit drink. Let the tablet dissolve before you drink the mixture. Don't swallow the tablets whole.
Only use the dose cup or oral syringe that your prescriber provides you with to measure out your methadone dose. Don't use household spoons because they aren't accurate.
Store the methadone liquid at room temperature. Keep the medication in the original container that it came in to protect it from light.
Tips for taking methadone for OUD:
When you start treatment with methadone for opioid use disorder, you'll need to go to a methadone clinic every day to take your methadone dose. Mark your appointment dates and times in your calendar so you don't miss any doses.
Be sure to continue to visit and follow up with your prescriber as scheduled, even after you get to a stable methadone dose to manage your OUD. This helps check your progress with treatment and adjust your treatment plan, if needed.
In general, your dose will depend on why you need methadone, how severe your symptoms are, and whether you're taking other opioids. Your prescriber will work closely with you to adjust your dose based on your individual needs. It's recommended to take the smallest amount of methadone necessary to manage your condition for the shortest period of time possible.
Long-term pain
If you're not already taking an opioid: The typical starting dose of methadone is 2.5 mg by mouth every 8 to 12 hours.
If you're switching from another opioid to methadone: Your prescriber will calculate your methadone dose based on the dose of the opioid you were taking. Methadone is taken by mouth, as directed by your prescriber.
Opioid use disorder (OUD)
Methadone is typically started in a healthcare setting (e.g., methadone clinic) under the direct supervision by a healthcare professional (HCP).
The typical starting dose is 20 mg to 30 mg by mouth at the first sign of opioid withdrawal. The HCP will observe you at the clinic for 2 to 4 hours and they might give you an additional 5 mg to 10 mg if your withdrawal symptoms haven't improved. The maximum dose on the first day of treatment is 40 mg.
Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.
Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.
Severely slowed breathing (respiratory depression)
Severe asthma
Medical conditions that cause blockage of the stomach passageway
Long-term pain that isn't relieved by non-opioid pain medications alone - except for Methadose brand name and its generics)
Treatment and maintenance of opioid use disorder (OUD) - all brand names and generics
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American College of Obstetricians and Gynecologists. (2017). Opioid use and opioid use disorder in pregnancy.
American College of Obstetricians and Gynecologists. (2021). Breastfeeding challenges. Obstetrics & Gynecology.
American Society of Addiction Medicine. (2019). The ASAM National Practice Guideline for the treatment of opioid use disorder.
Camber Pharmaceuticals, Inc. (2024). Methadone hydrochloride- methadone hydrochloride tablet [package insert]. DailyMed.
Centers for Disease Control and Prevention. (2024). About opioid use during pregnancy.
Department of Justice/Drug Enforcement Administration. (2020). Narcotics.
Dowell, D., et al. (2022). CDC Clinical Practice Guideline for prescribing opioids for pain — United States, 2022. Morbidity and Mortality Weekly Report.
Fenn, J. M., et al. (2015). Increases in body mass index following initiation of methadone treatment. Journal of Substance Abuse Treatment.
Jansson, L. M., et al. (2019). Neonatal abstinence syndrome. Pediatric Clinics of North America.
MedlinePlus. (2023). Prescription drug misuse.
National Institute of Diabetes and Digestive and Kidney Diseases. (2018). Symptoms & causes of adrenal insufficiency & Addison's disease.
National Institute of Diabetes and Digestive and Kidney Diseases. (n.d.). Adrenal insufficiency & Addison’s disease.
Peles, E., et al. (2016). Risk factors for weight gain during methadone maintenance treatment. Substance Use and Addiction Journal.
SpecGx LLC. (2023). Methadose dispersible- methadone hydrochloride tablet; Methadone hydrochloride- methadone hydrochloride tablet [package insert]. DailyMed.
SpecGx LLC. (2023). Methadose- methadone hydrochloride concentrate; Methadose Sugar-Free- methadone hydrochloride concentrate [package insert]. DailyMed.
SpecGx LLC. (2024). Methadone hydrochloride- methadone hydrochloride solution [package insert]. DailyMed.
U.S. Food and Drug Administration. (2022). Drug disposal: Drug take back locations.
XLCare Pharmaceuticals, Inc. (2024). Methadone hydrochloride- methadone hydrochloride tablet [package insert]. DailyMed.
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