If you wish to know more about Methadone, your options, and the prescribing process, read on as we explore the methods of administration, how patients are supplied with methadone, and what you should do before you decide to use methadone.
- Methadone is a usual prescription drug that healthcare professionals use for managing chronic pain in many patients.
- DEA-registered addiction professional also makes use of methadone in their substance use treatment.
Methadone is the white-powdery substance that is often supplied in a tablet form.
The preparation has been designed to allow patients to swallow it as a whole. There are also other tablets containing methadone that are made to be dissolved first in liquid before ingesting. Methadone is also readily available in a ready-to-drink mix, although another option for using it is a concentrate. With a concentrate, methadone is first mixed in water or fruit juice pre-administration. You may also take methadone as supplied in a liquid form and injected.
Some points to remember about using methadone:
- Methadone comes in tablets with 5 mg and 10 mg doses. The 5 mg tablet looks white or off-white with a rectangular shape while the 10 mg tablets are also white to off-white with a modified rectangular convex shape.
- Methadone hydrochloride USP or Methadone Oral Concentrate is usually a cherry-flavored liquid concentrate containing 10 mg of methadone per mL.
- Sugar-Free Methadone Oral Concentrate is a dye-free, unflavored concentrate with 10 mg of methadone/mL.
- Methadone Diskets contain 40 mg doses that can be broken in two to yield (2) 20 mg doses or in four to make (4) 10 mg doses. You need to disperse dose in 120 mL of liquid like water, juice or any non-alcoholic beverage.
- The oral liquid has varied doses so your prescription needs to indicate the mg dose.
- Methadone Hydrochloride Injection is administered by inpatient staff in an emergency situation for no longer than three days. Each mL of injection contains 0.029 mmol or 10 mg of methadone equivalent to 8.95 mg of free base methadone.
For management of chronic pain in adults:
- The initial dose for opiate-naive is 2.5 mg taken orally every 8-12 hours.
- Initial dose for patients who switched from other oral opioids as well as for the infirmed and elderly is 20 mg/day or 10mg For patients who switched from IV or injectable methadone to oral use, the conversion ratio for oral to parenteral is 2:1 that is 10 mg oral and 5 mg parenteral
For management of withdrawal from opiate:
- According to 42 CFR Section 8.12, treatment standard is 20-30 mg of initial oral dose with maximum dose for the first use being 30 mg and initial daily dose afterward should not exceed more than 40 mg daily.
- For IV or Injection, the dose is converted 2:1 ratio so oral users dosing 10 mg will dose 5 mg for parenteral methadone.
For pain management in adults that are opiate-naive, doses are 2.5-10 mg of first IV dose every 8-12 hours. Oral use is as needed as there is an increasing risk of cases of overdose as well as death with long-acting opioids.