Methadone may be habit forming. Take methadone exactly as directed. Do not take more or less of it, take it more often, stop takng it suddenly, or take it for a longer period of time or in a different way than prescribed by your doctor. Tell your doctor if you or anyone in your family drinks or has ever drunk large amounts of alcohol, uses or has ever used street drugs, or has overused prescription medications, or has had an overdose, or if you have or have ever had depression or another mental illness.
Methadone may cause serious or life-threatening breathing problems, especially during the first 24 to 72 hours of your treatment and any time your dose is increased. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath.
Taking certain other medications, drinking alcohol, or using street drugs during your treatment with methadone may increase the risk that you will experience serious, life-threatening side effects such as breathing problems, sedation, or coma. Tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Your doctor may need to change the doses of your medications and will monitor you carefully.
Methadone may harm or cause death to other people who take your medication, especially children. Keep methadone in a safe place so that no one else can take it accidentally or on purpose.
Methadone may cause QT prolongation (a rare heart problem that may cause irregular heartbeat, fainting, or sudden death). If you experience any of the following symptoms, call your doctor immediately: pounding heartbeat, dizziness, lightheadedness, or fainting.
Tell your doctor if you are pregnant or plan to become pregnant. If you take methadone regularly during your pregnancy, your baby may experience life-threatening withdrawal symptoms after birth.
Talk to your doctor about the risks of taking methadone for your condition.
Your doctor or pharmacist will give you the manufacturer's patient information sheet (Medication Guide) when you begin treatment with methadone and each time you fill your prescription if a Medication Guide is available for the methadone product you are taking. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit the Food and Drug Administration (FDA) website ( https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm ) or the manufacturer's website to obtain the Medication Guide.Use of methadone to treat opiate addiction:
If you have been addicted to an opiate (narcotic drug such as heroin), and you are taking methadone to help you stop taking or continue not taking the drug, you must enroll in a treatment program. You may have to take your medication at the treatment program facility under the supervision of the program staff. Ask your doctor or the treatment program staff if you have any questions about enrolling in the program or taking or getting your medication.
Why is this medicine prescribed?
Methadone is used to relieve severe pain. Methadone also is used to treat opioid addiction (physical and psychological reliance on a chemical found in prescription and street drugs). Methadone is in a class of medications called opiate (narcotic) analgesics. Methadone works to treat pain by changing the way the brain and nervous system respond to pain. It works to treat people who were addicted to opiate drugs by producing similar effects and preventing withdrawal symptoms.
Are there other uses for this medicine?
This medication may be prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Methadone comes as a tablet, a dispersible tablet (tablet that can be dissolved in liquid), a solution (liquid), and a concentrated solution to take by mouth. When methadone is used to relieve pain, take every 8 to 12 hours. If you take methadone as part of a treatment program, your doctor will prescribe the dosing schedule that is best for you.
Do not chew or swallow the dispersible tablets before mixing in a liquid. If your doctor has told you to take only part of a tablet, break the tablet carefully along the lines that have been scored into it. Place the tablet or piece of the tablet in at least 120 mL (4 ounces) of water, orange juice, or a citrus fruit drink. Let it dissolve. Drink the entire mixture right away. If some tablet residue remains in the cup, add a small amount of liquid to the cup and drink it all.
Your doctor may change your dose of methadone during your treatment. Your doctor may decrease your dose or tell you to take methadone less often as your treatment continues. If you experience pain during your treatment, your doctor may increase your dose or may prescribe an additional medication to control your pain. Talk to your doctor about how you are feeling during your treatment with methadone. If you feel that your pain is not controlled or if your pain increases, becomes worse, or if you have new pain or an increased sensitivity to pain while you are taking methadone, call your doctor. Do not take extra doses of methadone or take doses of methadone earlier than they are scheduled even if you experience pain.
Talk to your doctor or pharmacist about access to rescue medicines, naloxone or nalmefene, while taking methadone. Rescue medications can reverse the life-threatening effects of an opioid overdose and are available over the counter or with a prescription. Make sure that you and your family members and people usually around you know how to recognize an overdose, how to use naloxone or nalmefene, and what to do until emergency medical help arrives. Your doctor or pharmacist will show you and others how to use it. If symptoms of an overdose occur, they should give the first dose of naloxone, call 911 immediately, and stay with you and watch you closely until emergency medical help arrives. If your symptoms return, the person should give you another dose of the rescue medication. Additional doses may be given every 2 to 3 minutes, if symptoms return before medical help arrives.
Do not stop taking methadone without talking to your doctor. Your doctor will probably want to decrease your dose gradually. If you suddenly stop taking methadone, you may experience withdrawal symptoms such as restlessness, teary eyes, runny nose, yawning, sweating, chills, muscle pain, widened pupils (black circles in the middle of the eyes), irritability, anxiety, backache, joint pain, weakness, stomach cramps, difficulty falling asleep or staying asleep, nausea, decreased appetite, vomiting, or diarrhea.
What special precautions should I follow?
Before taking methadone,
- tell your doctor or pharmacist if you are allergic to this drug, any part of this drug, or any other drugs, foods or substances. Tell your doctor or pharmacist about the allergy and what symptoms you had.
- some medications should not be taken with methadone. Make sure you have discussed any medications you are currently taking or plan to take before starting methadone with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking methadone, please get the advice of your doctor or pharmacist.
- tell your doctor or pharmacist if you are taking the following medications or have stopped taking them within the past two weeks: isocarboxazid, linezolid, methylene blue, phenelzine, selegiline or tranylcypromine.
- the following nonprescription or herbal products may interact with methadone: St. John's wort and tryptophan. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking methadone. Do not start these medications while taking methadone without discussing it with your healthcare provider.
- tell your doctor if you have slowed breathing, asthma, chronic pulmonary disease (COPD), or other lung problems;or have or have ever had a blockage in your intestine or paralytic ileus (condition in which digested food does not move through the intestines) or a blockage in the stomach or intestines. Your doctor may tell you not to take methadone.
- tell your doctor if you have or have ever had long QT syndrome or if you have or ever had a slow or irregular heartbeat; a brain tumor, or any condition that increases the amount of pressure in your brain; seizures; or thyroid, pancreas, gallbladder, heart, liver, or kidney disease.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking methadone, call your doctor.
- you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of taking methadone.
- you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- you should know that methadone may cause dizziness when you get up too quickly from a lying position. This is more common when you first start taking methadone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
- you should know that methadone may cause constipation. Talk to your doctor about changing your diet or using other medications to prevent or treat constipation while you are taking methadone.
- you should know to not drink alcoholic beverages while you are taking methadone. Alcohol can make the side effects from methadone worse.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget to take a dose?
If your doctor has told you to take methadone for pain, take the missed dose as soon as you remember it and then continue your regular dosing schedule. However, if it is almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- narrowing or widening of the pupils (black circles in the center of the eyes)
- slow or shallow breathing difficulty breathing,
- sleepiness, unable to respond or wake up
- cool, clammy, or blue skin
- slow heartbeat
What side effects can this medicine cause?
Methadone may cause side effects. Tell your doctor if any of these symptoms or those in the SPECIAL PRECAUTIONS section are severe or do not go away:
- headache
- nausea, vomiting
- sweating
- decreased sexual desire, inability to get or keep an erection
Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately or get emergency medical help:
- seizures
- rash; hives; itching; hoarseness; difficulty breathing or swallowing; or swelling of the face, mouth, tongue or throat
- extreme drowsiness
- agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, or diarrhea
- nausea, vomiting, loss of appetite, weakness, or dizziness
- new pain or pain from touch or doing ordinary tasks such as combing your hair
- difficulty swallowing, regurgitation (bringing up swallowed food into throat and mouth), pain in the chest area
- chest pain, changes in heartbeat
- unusual snoring or long pauses during breaths during sleep
Methadone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, out of reach of children, and in a location that is not easily accessible by others, including visitors to the home. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Dispose of any methadone that is outdated or no longer needed through a medicine take-back program. If you do not have a take-back program nearby or one that you can access promptly, flush any methadone tablets or solution that are outdated or no longer needed down the toilet. Talk to your pharmacist about the proper disposal of your medication.
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.orgWhat other information should I know?
Keep all appointments with your doctor or clinic.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking methadone.
This prescription is not refillable. If you continue to experience pain after you finish taking methadone, call your doctor. If you take this medication on a regular basis, be sure to schedule appointments with your doctor so that you do not run out of medication.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.