METHADONE (Paeds)
Mechanism of action:
Opioid analgesic
Ref: 4
Last update: 2021-02-20 |
Oral Solution: 1 mg/mL Tablets: 1 mg, 5 mg Suppositories: 3 mg, 6 mg, 10 mg, 20 mg (made locally; ordered as needed)
(IV form not available in Canada)
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Pediatrics: Analgesia:
- Conversion to methadone from other opioids takes at least 3 days and is to be supervised by the Acute, Complex or Palliative Pain Service.
- Dose of methadone depends on the opioid used, opioid dose and length of therapy.
Prevention of Iatrogenic Opioid withdrawal:
- Refer to PICU guidelines.
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- May only be ordered by physicians licensed to prescribe methadone
- Do not use methadone for breakthrough pain.
- Methadone should not be used in opioid naive patients (risk of respiratory depression)
- Monitoring: Obtain ECG prior to start of therapy (may cause QT interval prolongation and serious arrhythmia)
- Monitor respiratory, cardiovascular, mental status (Refer to Opioid Administration Guidelines)
- Many drug interactions; check with pharmacy
- Overdoses: Overdoses may be reversed with naloxone but as half-life of methadone is very long, naloxone infusion and admission to PICU may be required
- Rectal absorption is similar to PO but is more variable between patients. Titration is required. Suppositories can be dosed Q8H
Standard Prescription:
methadone__mg PO Q__H
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