METHADONE

Standard Prescription

methadone__mg PO Q__H

Dosages

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.

Mechanism of Action

Opioid analgesic

Forms Supplied

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)

Comments

  • 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

References

4

Last Edited

2021-02-20 19:16:08