Idaho News: Methadone

March 1, 2007 4:42 pm Topics: Pain management

Published in the March 2007 Idaho Board of Pharmacy Newsletter

Food and Drug Administration (FDA) has issued a public health advisory concerning the use of methadone. There have been reports of death and life-threatening side effects in patients taking methadone. These deaths and life-threatening side effects have occurred in patients newly starting methadone for pain control and in patients who have switched to methadone after being treated for pain with other strong narcotic pain relievers. Methadone can cause slow or shallow breathing and dangerous changes in heartbeat that may not be felt by the patient.
Prescribing methadone is complex. Methadone should only be prescribed for patients with moderate to severe pain when their pain is not improved with other non-narcotic pain relievers. Pain relief from a dose of methadone lasts about four to eight hours; however, methadone stays in the body much longer – from eight
to 59 hours. As a result, patients may feel the need for more pain relief before methadone is excreted from the body. Methadone may build up in the body to a toxic level if it is taken too often, if the amount taken is too high, or if it is taken with certain other medicines or supplements.
FDA is issuing this public health advisory to alert patients and their caregivers and health care professionals to the following important safety information:
 Patients should take methadone exactly as prescribed. Taking more methadone than prescribed can cause breathing to slow or stop and can cause death. A patient who does not experience good pain relief with the prescribed dose of methadone, should talk to his or her doctor.
 Patients taking methadone should not start or stop taking other medicines or dietary supplements without talking to their health care providers. Taking other medicines or dietary supplements may cause less pain relief. They may also cause a toxic buildup of methadone in the body leading to dangerous changes in breathing or heartbeat that may cause death.
 Health care professionals and patients should be aware of the signs of methadone overdose, which include trouble breathing or shallow breathing; extreme tiredness or sleepiness; blurred vision; inability to think, talk, or walk normally; and feeling faint, dizzy, or confused. If these signs occur, patients should get medical attention right away.
When dispensing methadone please consider the above information when counseling patients and possibly avoid a disastrous outcome.