Substances Authority for information on how to prevent and detect abuse or diversion of this product. Interactions with other CNS Depressants. Medscape – Detoxification, pain-specific dosing for Methadose, Dolophine opioids; Substantial interpatient variability, see prescribing information for guidance. Find patient medical information for Dolophine Oral on WebMD including its uses , side effects and safety, interactions, pictures, warnings and user ratings.
|Published (Last):||12 July 2011|
|PDF File Size:||3.28 Mb|
|ePub File Size:||6.1 Mb|
|Price:||Free* [*Free Regsitration Required]|
Methadone Dolophine, Methadose – Treatment – Hepatitis C Online
Intravenous, Subcutaneous, or Intramuscular dosage. Monitor patients for hypotension at the initiation of therapy and during dose titration. There is considerable individual variation in the rate of taper when informtaion methadone. Methadone has also been administered intravenously for patient controlled analgesia PCA via a rate controlled device as a bolus dose and as a continuous infusion. If a patient is taking methadone and experiences acute pain such as postoperative pain, analgesia may not be provided by the existing methadone dose; administration of another analgesic may be warranted.
Management infodmation respiratory depression should include observation, necessary supportive measures, and careful use of an opioid antagonist e.
Intravenous, Subcutaneous or Intramuscular dosage. Methadone should be reserved for patients in whom alternative treatment options e.
Drugs known to prexcribing the QT interval, potentiate hypokalemia, or reduce methadone elimination should be coadministered with a careful assessment of risks versus benefits. Send the page ” ” to a friend, relative, colleague informxtion yourself. Drug accumulation or prolonged duration of action can occur in patients with hepatic disease. Intravenous methadone should only be used on a temporary basis for patients who cannot take oral medication, such as hospitalized inpatients.
Women who received methadone maintenance therapy for opioid dependence during pregnancy who are stable may be encouraged to breast-feed, unless another prescriving e. Discontinue methadone and other serotonergic agents if serotonin syndrome dolpphine suspected and institute appropriate medical treatment.
Injectable methadone is not approved for the outpatient treatment of opioid dependence. Consider the benefits of breast-feeding along with the mother’s clinical need for methadone and any potential adverse effects on the breast-fed child from methadone or the underlying maternal condition.
Although the exact causal role of opioids in the clinical manifestations of hypogonadism is unknown, patients could experience libido decrease, impotence, amenorrhea, or infertility. Patients with chronic liver disease may require less frequent dosing intervals. In ambulatory patients, a somewhat slower schedule may be required.
The dose should be sufficient to keep withdrawal symptoms at a tolerable level. Serotonin syndrome symptoms may include mental status changes e. Accidental exposure, opioid-naive patients, potential for overdose or poisoning. There is considerable individual variation in the rate of taper tolerated.
The onset of symptoms generally occurs within several hours to a few days of concomitant use, but may occur later than that. Patients tolerant to other opioids may be incompletely tolerant to methadone; use caution when converting patients from other opioids to methadone. Extreme caution is recommended during initiation of treatment, conversion from one opiate to another, and dose titrations.
BOXED WARNING Angina, bradycardia, cardiac arrhythmias, cardiac disease, coronary artery disease, diabetes mellitus, females, heart failure, hypertension, hypocalcemia, hypokalemia, hypomagnesemia, hypotension, hypovolemia, long QT syndrome, malnutrition, myocardial infarction, orthostatic hypotension, QT prolongation, thyroid disease.
Use methadone for severe pain during pregnancy only if the potential benefit justifies the potential risk to the fetus. Initially, use a 2: Medical withdrawal from methadone should be done in decrements as tolerated by the patient on a daily basis or at 2-day intervals.
To discourage abuse, the smallest appropriate quantity of methadone should be dispensed, and proper disposal instructions for unused drug should be given to patients. These adverse effects can lead to other consequences such as falls.
It is possible to treat these patients with an opioid agonist from the phenylpiperidine subclass fentanyl or meperidine or the phenanthrene subclass codeine, hydromorphone, and oxycodone. Methadone and other opiate agonists can cause urinary retention and oliguria due to increasing the tension of the detrusor muscle.
In addition to slowing the rate of cardiac repolarization thus lengthening the QT interval, methadone may produce cholinergic side effects by stimulating medullary vagal nuclei causing bradycardia and induce the release of histamine causing peripheral vasodilation. If concurrent use is necessary, use the lowest effective doses and minimum treatment durations possible and monitor patients closely for signs and symptoms of respiratory depression and sedation.
Benefits of methadone therapy during pregnancy include assisting women staying free of heroin or other opioids, increasing prenatal care, lessening the possibility preescribing fetal death, and reducing the risk of HIV and hepatitis infection.
Respiratory depression may persist for a significant period of time after discontinuation of methadone and patients require close monitoring until their respiratory rate has stabilized. The total daily oral dose on Day 1 should not ordinarily exceed 40 mg. Dosage adjustments on subsequent days should be based on withdrawal symptom control at the time of expected peak methadone activity 2 dolophinw 4 hours after dosing.
Patients should seek immediate medical attention if they experience symptoms such as nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, or hypotension.
Methadone should be used cautiously in patients with cardiac arrhythmias, hypokalemia, hypomagnesemia, hypotension, hypovolemia, or orthostatic hypotension. In acute situations, patients require close monitoring to avoid excessive toxicity. It is important to note respiratory depressant effects occur later and persist longer than peak analgesic effects. Use methadone with caution in patients with adrenal insufficiency i.