Uses
What is methadone used for?
Methadone is commonly used for the following conditions.
- Management of severe, chronic pain
- Detoxification from opioids in people with an opioid use disorder
- Maintenance of recovery in people with an opioid use disorder
Methadone may also be used for other conditions as determined by your healthcare provider.
How does methadone work (mechanism of action)?
Methadone works by activating opioid receptors. This produces an effect similar to other prescription opioids like morphine. Activating opioid receptors reduces the feeling of pain in the body.
How is methadone supplied (dosage forms)?
Brands and other names
- Diskets
- Dolophine
- Methadose
Dosage forms and strengths
- 10 mg/mL oral concentrate
- 5 mg/5 mL, 10 mg/5 mL oral solution
- 5 mg, 10 mg oral tablets
- 40 mg dispersible tablets for oral suspension
Methadone is also available in injectable forms.
How should I store methadone?
Methadone should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of methadone?
The most common side effects of methadone are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Lightheadedness or dizziness
- Sleepiness or tiredness
- Nausea or vomiting
- Sweating
- Constipation
- Headache
- Stomach pain
There may be other side effects of methadone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of methadone?
While less common, the most serious side effects of methadone are described below, along with what to do if they happen.
Severe Allergic Reactions. Methadone may cause allergic reactions, which can be serious. Stop taking methadone and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Increased Pain and Pain Sensitivity. Methadone may cause allodynia, which is when you have pain from something that normally does not cause pain such as brushing your hair. Methadone may also cause opioid induced hyperalgesia, which is when something that causes pain can make you feel more intense pain. Contact your healthcare provider right away if you have pain from things that did not cause pain before or an increase in pain intensity. It is very important to not take more methadone if your pain feels worse, as this may cause significant breathing problems.
Breathing Problems. Methadone may cause slow or shallow breathing, especially if you have breathing problems from another condition like asthma or chronic obstructive pulmonary disease (COPD) or take other medicines that can slow your breathing. Tell your healthcare provider if you develop severe sleepiness or trouble breathing, especially when you start methadone or when your dose is increased. Get emergency help if you have any of the following symptoms.
- Changes in the color of your skin, including bluish color to your lips and fingernails
- Confusion
- Shortness of breath
- Feeling dizzy, lightheaded, or fainting
- Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
- Slow or shallow breathing
- Excessive sleepiness or trouble staying awake
Risk of Misuse and Addiction. Misusing methadone can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take methadone exactly as prescribed. Tell your healthcare provider if you feel that methadone is not working. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.
- Sudden confusion or feeling disoriented
- Feeling paranoid
- Suicidal thoughts or actions
- Seizures
- Trouble breathing
Heart Rhythm Changes. Methadone may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
Serotonin Syndrome. Serotonin syndrome is when there is too much of a substance called serotonin in your body. Methadone can cause serotonin syndrome when it is taken with other medicines that affect serotonin. This condition can be life-threatening. Tell your healthcare provider about all medicines you take before taking any new medicine, including methadone. Get emergency help if you have any of the following symptoms of serotonin syndrome.
- Sweating, fever, or flushing
- Confusion
- Feeling agitated or restless
- Seeing or hearing unusual things
- Dizziness
- Fast or racing heartbeat
- Nausea, vomiting, or diarrhea
- Muscle twitching, stiffness, or tremor
- Seizures
Reduced Adrenal Function. Long-term use of methadone can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency.
- Nausea and vomiting
- Weakness, tiredness, or lack of energy
- Low blood pressure
Low Blood Pressure (Hypotension). Methadone may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Confusion
- Feeling weak or tired
Seizures. Methadone may cause seizures, especially if you have a seizure disorder. There are many different types of seizures and some of them are not easy to recognize. Stop taking methadone and call your healthcare provider if you have any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Low Blood Sugar (Hypoglycemia). Methadone can cause low blood sugar, which can be serious and may lead to death. You may need to check your blood sugar more often if you have changes to your diet, exercise regimen, or medicines for diabetes. Do not use methadone and call your healthcare provider right away if you have any of the following symptoms of hypoglycemia.
- Headache
- Crankiness or anxiety
- Hunger
- Dizziness or confusion
- Blurry vision
- Slurred speech
- Sweating
- Feeling jittery or shakiness
- Fast heartbeat
- Seizures
Warnings & Precautions
Who should not use methadone?
Allergies to Ingredients. People who are allergic to any of the following should not take methadone.
- Methadone
- Dolophine
- Diskets
- Methadose
Your pharmacist can tell you all of the ingredients in the specific methadone products they stock.
Lung problems. Methadone should not be used if you have severe asthma, trouble breathing, or other lung problems. Methadone can make these conditions worse.
Gut Blockage. Methadone should not be used if you have a blockage of your gut (bowel obstruction) or a narrowing of the stomach or intestines. Methadone can make these conditions worse.
Slowed Gut Movement. Paralytic ileus is a type of ileus where your intestines are unable to move food through them. Methadone can make this condition worse.
What should I know about methadone before using it?
Do not take methadone unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share methadone with other people, even if they have the same condition as you. It may harm them.
Keep methadone out of the reach of children. Methadone may cause children to have serious breathing problems and may cause them to stop breathing if they take even one dose by accident. Methadone is a controlled substance because it can be misused or lead to dependence. Store methadone in a safe place to protect it from theft. It is illegal to sell or give away this medicine.
Methadone can cause physical dependence, which means your body relies on the medicine. If you stop methadone suddenly, it could lead to withdrawal symptoms, which may require you to go to the hospital. Physical dependence is not necessarily a sign that you have developed a substance use disorder. Do not stop taking methadone without talking with your healthcare provider. Your healthcare provider can tell you how to stop methadone to reduce the risk of withdrawal reactions. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.
- Sweating
- Shaking more than normal
- Feeling more hot or cold than normal
- Runny nose
- Watery eyes
- Goosebumps
- Vomiting, diarrhea
- Muscle aches
For liquid methadone, use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist to recommend an appropriate measuring device.
Methadone is available as many different products that are taken in different ways. Ask your healthcare provider to show you how to use the methadone product you have on hand. Proper use is very important to avoid serious problems, including death.
People taking methadone should have naloxone available in the event of an emergency. Methadone is a medicine which is a type of opioid and may cause a bad reaction where your breathing slows or potentially stops. Naloxone is a medicine used to reverse the effects of opioids. Your healthcare provider can show you and your loved ones how to use and where to get naloxone. If naloxone is used, be sure to call 911.
Tell all of your healthcare providers that you are taking methadone. Methadone can cause life-threatening problems when used with certain medicines and requires special monitoring from your healthcare provider. It is important for all of your healthcare providers to know this so that they can provide you with appropriate care.
Long-term use of methadone may affect your ability to become pregnant or get a partner pregnant. Talk with your healthcare provider if you have any concerns.
Methadone can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how methadone affects you.
People who are 65 years of age or older can be at greater risk for some side effects from methadone. Talk to your healthcare provider about your risks if you are in this age group.
If you take methadone for opioid use disorder, you will get your medicine from your treatment program. Regular pharmacies can only dispense methadone to people who are being treated for pain.
Methadone works best for people with an opioid use disorder when the medicine is used with counseling, behavioral therapy, and support. Keep all counseling appointments your healthcare provider recommends.
Dispose of expired, unwanted, or unused methadone right away by taking your medicine to a local take-back site. If one is not available, you can mix medicine with dirt, coffee grounds, or cat litter, then place the mixture in a sealed plastic bag and throw the bag in the trash. You can also ask your healthcare provider about safe disposal kits and where you can get them.
What should I tell my healthcare provider before using methadone?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if methadone is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Head injury or brain tumor
- Seizures
- Liver, kidney, or thyroid problems
- Difficulty urinating (peeing)
- Drink large amounts of alcohol or alcohol use disorder
- Mental health problems
- History of misusing street or prescription medicines or living with someone with this problem
- Heart problems, including heart rhythm problems
- Pancreas or gallbladder problems
- Substance use disorder
- Breathing problems
- Diabetes
- Electrolyte imbalance, such as low levels of potassium or magnesium
Other Medicines and Supplements. Methadone may interact with other medicines and supplements. Before using/taking methadone, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. See the Interactions section for more details.
Pregnancy. Methadone may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take methadone while you are pregnant or trying to get pregnant. If you take methadone on a regular basis during pregnancy, your baby may have withdrawal symptoms that can be life-threatening. Tell your healthcare provider if you took methadone during your pregnancy, especially near the end of your pregnancy.
Breastfeeding. Methadone passes into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed. Your healthcare provider will advise you if you should take methadone while breastfeeding.
Interactions
Does methadone interact with foods or drinks?
There are no known interactions between methadone and foods or non-alcoholic drinks.
Do not drink alcohol or use over-the-counter medicines that contain alcohol. The combination of methadone and alcohol may cause life-threatening breathing problems.
Does methadone interact with other medicines (drug interactions)?
- Medicines that can cause QT prolongation, which is a potentially dangerous heart rhythm problem, such as amiodarone, erythromycin, or sotalol
- A mixed agonist/antagonist or partial agonist opioid analgesic, such as buprenorphine (Butrans, Sublocade), butorphanol, and others, which is used to treat certain types of pain or opioid use disorder
- A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
- A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
- An antipsychotic, which is a medicine for certain mental health conditions
- A muscle relaxant, such as carisoprodol (Soma), cyclobenzaprine, or tizanidine (Zanaflex)
- An opioid, such as oxycodone, morphine, codeine, or fentanyl, which is a medicine used for certain types of pain
- A barbiturate, such as phenobarbital, butalbital, or primidone, which is a medicine that may be used to treat insomnia, migraines, or seizures
- A selective serotonin reuptake inhibitor (SSRI), such as fluoxetine, paroxetine, or sertraline, which is a medicine commonly used for anxiety and depression
- Carbamazepine (Carbatrol, Tegretol, and others), which is a medicine commonly used to treat seizures or nerve pain
- A serotonin and norepinephrine reuptake inhibitor (SNRI), such as duloxetine or venlafaxine, which is a medicine commonly used for anxiety and depression
- A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
- A tricyclic antidepressant, such as amitriptyline, nortriptyline, or protriptyline, even if it is not used for depression
- A triptan, such as sumatriptan (Imitrex and others), eletriptan (Relpax), and others, which is a medicine commonly used to treat migraines
- An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
- Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, and medicines for anxiety
Many other medicines may alter the blood levels of methadone. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with methadone. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much methadone?
If you or someone else has used too much methadone, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of methadone?
If you take methadone for pain and miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.
If you take methadone for opioid use disorder and miss a dose, take your next dose the following day as scheduled. Do not take extra doses.
Are you currently using Methadone?
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