Methadone is used to treat moderate to severe pain when other pain medicines do not work. Sometimes methadone is used to treat drug dependency and addiction. Methadone, Intensol™ and Methadose® are brand names for the methadone liquid that is taken by mouth. Dolophine® is the brand name for methadone tablets. Methadone Diskets® is the brand name for tablets that dissolve.
- When taken by mouth, the effects of methadone are first seen 30 to 60 minutes after taking the medicine. The first doses may ease pain for 6 to 8 hours. After many doses are taken, the drug builds up in the body and then the pain-killing effects may last from 22 to 48 hours after one dose.
- When given by injection, methadone’s effects may be seen after only 10 to 20 minutes. The pain-killing effects are best around 1 to 2 hours after the shot is given.
- If your child is allergic to methadone, he or she should not take this medicine.
- Methadone is a narcotic. Your child’s doctor has ordered this medicine for him only. Take it only as told by the doctor or dentist because it can be addicting. Do not let anyone else take this medicine.
- Be sure to tell the doctor if your child has severe asthma, serious breathing problems, bowel blockage or digestion problems.
- If a patient thinks she might be pregnant, she should tell the doctor before starting this or any medicine. This medicine may cause problems, such as withdrawal, in the baby when he or she is born if the mother has taken it during pregnancy.
- If a patient is breastfeeding, she should tell her doctor before she begins taking this or any medicine. This medicine can pass into breast milk and cause side effects in the baby.
Methadone can cause tolerance, physical dependence and psychological dependence in some people.
- Tolerance is when your body gets used to the medicine. It may seem like it does not work as well over time. More of the drug is needed to get the same effects over time. Tolerance to methadone can happen very quickly. Check with your doctor if you feel it is not working as well as it used to.
- Physical dependence is the urge to keep taking the drug to avoid withdrawal symptoms, like fast heart rate, high blood pressure, sweating, irritability, vomiting and diarrhea.
- Psychological dependence is the urge to keep taking the drug to “get high.”
How to Give This Medicine by Mouth
- Read the label well. Make sure you are giving your child the right amount. It is easy to confuse the many different dosage forms and strengths.
- Stay with your child until he or she has swallowed the dose of medicine.
- Give the exact dose of medicine that the doctor ordered. Stay with your child until he has swallowed the dose of medicine.
- Your child will need to be watched closely to avoid serious side effects.
- Because methadone builds up in the body, smaller amounts are given less often the longer a patient takes the medicine.
Giving the liquid medicine:
- Give this medicine with food to prevent upset stomach.
- A liquid is given if your child cannot swallow pills. Liquid methadone may be mixed with 1/4 cup of water before drinking. There are different strengths of liquid. Make sure you have the right one.
- Children who have feeding tubes can also be given the liquid. Flush the feeding tube before and after the medicine is given.
- Measure liquid doses with care. Use the measuring device that comes with the medicine. If you do not have one, use an oral syringe, a medicine dropper, a medicine spoon or a children’s medicine cup from your pharmacist. Do not use kitchen spoons.
- Make sure your child drinks plenty of caffeine-free liquid every day unless told by the doctor or nurse to drink less.
Giving the tablet that dissolves:
- Place the tablet in liquid and let it dissolve before giving it to your child. If there is medicine left in the cup, add a little liquid and give it to your child.
- Do not let your child to chew or swallow the dissolvable tablet.
If You Forget to Give a Dose
If you miss a dose, give the medicine as soon as you can. If it is almost time for the next dose do not give the missed dose at all. Do not double the next dose. Instead, go back to your regular dosing schedule. Many times, this medicine is given as needed. If you have any questions about this, ask your child’s doctor or pharmacist.
If a Dose Is Vomited
Throwing up (vomiting) is a side effect of this medicine. Call the doctor if your child keeps vomiting with the doses. He may need to take medicine to help control these side effects.
- Store all medicine out of the reach of children and others who may use it the wrong way.
- Always keep medicine in the original container from the pharmacy.
- Do not keep the liquid form in the refrigerator. Store at room temperature.
- Light and moisture make this medicine not work as well. Moisture will dissolve the dissolvable tablets. Keep the bottle tightly closed and store it in a dark, dry place. Do not store it in the bathroom or above the kitchen sink.
- Keep this medicine away from heat or direct sunlight.
- Do not use this medicine after the expiration date printed on the container.
Drug and Nutrient Interactions
- This medicine should not be taken with some foods or medicines. Tell your child’s doctor and pharmacist about all the medicines your child takes to make sure they are safe to take with methadone.
- Your child should not drink alcohol. Taking this medicine with alcohol can cause sleepiness and can be dangerous. Some cold medicines, cough syrups and mouthwashes contain alcohol.
- Your child should not drink grapefruit juice. It may cause increased side effects from methadone.
- Your child should not take St. John’s Wort while on methadone.
- Some of your child’s other medicines may need to be changed because they may have the same side effects as methadone. Some medicines decrease blood levels and cause withdrawal symptoms. Some medicines mix with methadone to increase blood levels and cause methadone side effects.
Possible Side Effects
- Confusion, dizziness, sedation, or feeling “high”
- Itchy skin
- Drug dependency - physical or mental
- Small pupils in the eyes
- Lowered heart rate, blood pressure, and breathing rate
- Nausea or vomiting
What to Do about Side Effects
- Stop giving the medicine and call your child’s doctor if your child gets a skin rash.
- If your child gets drowsy or sleepy, do not let him ride a bike, operate machinery, like a lawnmower or car, or take part in things where he must stay alert and awake.
- These medicines may be used to treat side effects: Benadryl® and Zofran® for itchy skin; Colace®, Dulcolax® or Miralax® for constipation; Zofran® for nausea and vomiting.
When to Call for Emergency Help
Call 911 immediately if your child shows:
- Signs of a life-threatening reaction, like wheezing, tight chest, fever, itching, a bad cough, blue skin, fits, or swelling of the face, lips, tongue or throat.
- Sign of an overdose, like extreme sleepiness, being hard to wake up, no breathing, slow heart rate or blue skin.
When to Call the Doctor
Call the doctor if your child has these signs:
- Trouble breathing
- Severe dizziness or passing out
- Fast heartbeat
- Feeling extremely tired or weak
- Severe nausea or vomiting
- Poor pain control
- A major change in thinking clearly and logically
- Severe constipation
- Your child is no better, or you think he is worse
- Call the doctor if any of this information concerns or confuses you.
- Call the doctor if any of the common side effects occur, continue to bother your child or do not get better after taking the medicine.
- Do not give non-prescription medicines, such as acetaminophen, aspirin, antacids or cold medicines, without checking with your child's doctor or pharmacist first.
- Your child should not drink alcohol. Mixing this medicine with alcohol can depress your child’s nervous system and breathing. This can be very dangerous. Some cold medicines, cough syrups and mouthwashes contain alcohol. Check with your child’s doctor or pharmacist before giving non-prescription medicines.
- Methadone is an opioid. The doctor has ordered methadone for your child only. Do not let anyone else take this medicine. It should be taken only as told by the doctor or dentist because it can be habit-forming.
- Do not stop giving this medicine or change the amount given without talking with your child's doctor or pharmacist first.
- Tell your child's teacher, school nurse, coach, babysitter and others your child is taking this medicine and what side effects to watch for.
- Your child's school will need a note from you and from the doctor if the medicine is to be given at school by the school nurse.
- Tell your child's doctor and pharmacist if your child has a strange or allergic reaction to any medicine.
- Learn the name, spelling and dose of this medicine. Also, teach your child if he or she is old enough. You will need to know this information when you call your child’s doctor or pharmacist.
- Bring all your child's medicines with you in the original containers whenever your child sees a doctor, goes to an emergency room or is admitted to the hospital. This helps doctors who may not know your child.
- It is important to keep a record of when the medicine is given. You may use a calendar or the Helping Hand, Medication Record, HH-V-1. If your child has trouble taking medicine, ask your nurse for the Helping Hand, Medications: How to Give by Mouth, HH-IV-28.
- If your child takes too much of this medicine, or if someone else takes this medicine, first call the Central Ohio Poison Center at 1-800-222-1222 (TTY 614-228-2272). They will tell you what to do.
- If you carry medicine in your purse, keep it in its childproof container and keep your purse out of the reach of children.
- When your doctor decides this medicine is no longer needed, flush the rest of the medicine down the toilet.
Other Advice about the Medicine
- This medicine cannot be refilled. Your child’s doctor needs to write a new prescription each time he or she runs out of medicine and needs more.
- Get a new prescription from your child’s doctor at least ______ days before the last dose is given. This is very important.
- Have your pharmacist give you 2 labeled containers if your child care provider will be giving this medicine.
- Some pharmacies may not have methadone. Please ask your nurse to call your pharmacy before you leave the hospital to see if they have this medicine or can order it for you. You may also have the prescription filled at the Nationwide Children’s Hospital pharmacy.
- Expect to have regular follow-up appointments with your child's doctor. If your child cannot keep the appointment, call to reschedule.
- If you have any questions, be sure to ask your child’s doctor, nurse or pharmacist. Write down all your questions. Bring the list with you when you see the doctor.
HH-V-232 11/09, Revised 6/15 Copyright 2009, Nationwide Children’s Hospital