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Methadone Warnings and Precautions

Specific Methadone Warnings and Precautions

Some warnings and precautions to be aware of prior to taking methadone include the following:
 
  • Deaths have been reported when healthcare providers switched patients with chronic pain to methadone from other opioid medications. Typically, this occurred when healthcare providers recommended an overly aggressive methadone dosage.
This medication's ability to cause dangerous breathing problems lasts longer than its ability to control pain, especially when a patient first starts treatment. Therefore, healthcare providers should monitor people closely when methadone is first started or the dosage is increased.
  • Methadone can cause a potentially dangerous change in the heart rhythm known as QT prolongation. This is most common in people taking large, multiple doses for pain treatment, although it has also been reported when the drug was used for addiction treatment. Let your healthcare provider know if you develop signs of an irregular heart rhythm, such as:
 
    • Lightheadedness
    • Dizziness
    • Fainting
    • Heart palpitations.
Some experts recommend that people be given an electrocardiogram (ECG or EKG) before treatment and periodically thereafter.
  • Although any healthcare provider who can prescribe controlled substances may prescribe methadone for pain control, this drug can only be used for addiction treatment in special treatment facilities (see Methadone Clinics), except in rare circumstances.
     
  • Methadone is a narcotic medication with significant potential for abuse, although it is often used to treat addiction. Do not take the drug more frequently, longer, or at higher doses than prescribed. If you feel you may be developing a problem with addiction or abuse, seek help from your healthcare provider.
     
  • Do not drive or operate heavy machinery until you know how methadone affects you. Your reflexes and reaction times may be significantly affected, even if you feel fine.
     
  • Methadone can cause slow and irregular breathing. In severe situations, this may lead to life-threatening complications. This may be especially dangerous in people with lung problems or if methadone is combined with alcohol or other drugs or substances that can cause drowsiness.
     
  • This medication can cause problems in people with head injuries or high intercranial pressure. Methadone should only be used with extreme caution in such circumstances.
     
  • Methadone can interfere with the diagnosis of many conditions that cause severe abdominal (stomach) pain.
     
  • Check with your healthcare provider before taking this drug if you have hypothyroidism, Addison's disease, an enlarged prostate, kidney disease, liver disease, sickle cell anemia, or epilepsy, as methadone may not be the best choice for you.
     
  • Methadone can potentially interact with several other medications (see Methadone Drug Interactions).
     
  • Methadone is considered a pregnancy Category C medication. This means that it may not be safe for use during pregnancy, although the full risks are not known (see Methadone and Pregnancy).
     
  • Methadone passes through breast milk. Therefore, if you are breastfeeding or plan to start, discuss this with your healthcare provider prior to beginning treatment (see Methadone and Breastfeeding).
     
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