Methadone HCL 40mg

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What Is Methadone Hydrochloride and How Does It Work?

Methadone is used to treat addiction to opioids (such as heroin) as part of an approved treatment program. Methadone belongs to a class of drugs known as opioid (narcotic) analgesics. It helps prevent withdrawal symptoms caused by stopping other opioids.

Methadone may also be used to treat severe pain. Do not use methadone to relieve pain that is mild or that will go away in a few days. Methadone is not for occasional (“as needed”) use.

Methadone is available under the following different brand and other names: Methadose, and Dolophine.

Dosages of Methadone Hydrochloride

Adult Dosage Forms & Strengths

Injectable solution: Schedule II
10mg/mL

Tablet: Schedule II
5mg
10mg
40mg (pediatric)

Dispersible tablet: Schedule II
40mg

Oral solution: Schedule II
5mg/5mL
10mg/5mL

Oral concentrate solution: Schedule II
10mg/mL

Dosage Considerations — Should Be Given As Follows:

For Adults with Chronic Severe Pain

Indicated for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate

Opioid-naive patients: 2.5 mg taken orally once every 8-12 hours; titrate slowly with dose increases no more frequent than every 3-5 days

Opioid-tolerant patients
Discontinue all other around-the-clock opioids
Substantial inter-patient variability, see prescribing information for guidance

Opioid-tolerant definition
Use of higher starting doses in patients who are not opioid tolerant may cause fatal respiratory depression
Patients who are opioid tolerant are those receiving, for 1 week or longer, at least 60 mg/day oral morphine, 25 mcg/hour transdermal fentanyl, 30 mg/day oral oxycodone, 8 mg/day oral hydromorphone, 25 mg/day oral oxymorphone, or an equianalgesic dose of another opioid

Limitations of use
Use of the risks of addiction, abuse, and misuse with opioids, even at recommended doses, and because of the greater risks of overdose and death with extended-release opioid formulations, reserve for patients whom alternative treatment options (e.g., non-opioid analgesics or immediate-release opioids) are ineffective, not tolerated, or would be otherwise inadequate to provide sufficient management of pain
Not indicated for acute pain or as an as needed analgesic

Detoxification

20-30 mg taken orally once daily or minimum dosage necessary to suppress withdrawal; may be titrated to 40 mg/day in divided doses and continued for 2-3 days, then decreased 20% daily as tolerated

Dosing Modifications

Renal impairment (CrCl less than 10mL/min): 50-75% of normal dose

Hepatic impairment: Not recommended in severe liver disease

Dosing Considerations

Conversion from oral to parenteral: Parenteral-to-oral ratio, 1:2 (5 mg parenteral = 10 mg taken orally)

To convert to methadone from another opioid, use available conversion factors to obtain estimated dose

Do not abruptly discontinue methadone in a physically dependent patient

Pediatric

Pain (Off-label)

0.7 mg/kg/day orally/subcutaneously/intravenously(IV)/intramuscularly (IM) divided once every 6 hours as needed; not to exceed 10 mg/dose

Opiate Withdrawal (Off-label)

Neonates: 0.05-0.2 mg/kg taken orally once every 12-24 hours; reduce dose by 10-20% per week over 4-6 weeks; adjust tapering on signs and symptoms of withdrawal

Geriatric

Pain

2.5 mg orally or intramuscularly (IM) once every 8-12 hours; titrate slowly with dose increases no more frequent than every 3-5 days

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Detoxification

20-30 mg taken orally once daily or minimum dosage necessary to suppress withdrawal.

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Methadone is a long-lasting opioid medication used in the treatment of pain and narcotic addiction. The 5mg and 10 mg formulations indicated for the treatment of pain will continue to be available to all authorized registrants, including retail pharmacies.

The DEA and pharmaceutical industry agree that the reported increase in methadone-related adverse events merits action and further agree to a united effort to assure that methadone is properly distributed, consistent with its approved uses. Industry and the federal entities involved commit to monitor the progress of this initiative.

This medicine is a narcotic pain reliever.

Regulation

Secretion of growth hormone (GH) in the pituitary is regulated by the neurosecretory nuclei of the hypothalamus. These cells release the peptides Growth hormone-releasing hormone (GHRH or somatocrinin) and Growth hormone-inhibiting hormone (GHIH or somatostatin) into the hypophyseal portal venous blood surrounding the pituitary.

Somatotropic cells in the anterior pituitary gland then synthesize and secrete GH in a pulsatile manner, in response to these stimuli by the hypothalamus. The largest and most predictable of these GH peaks occurs about an hour after onset of sleep with plasma levels of 13 to 72 ng/mL. Otherwise there is wide variation between days and individuals. Nearly fifty percent of GH secretion occurs during the third and fourth NREM sleep stages.[Surges of secretion during the day occur at 3- to 5-hour intervals. The plasma concentration of GH during these peaks may range from 5 to even 45 ng/mL. Between the peaks, basal GH levels are low, usually less than 5 ng/mL for most of the day and night. Additional analysis of the pulsatile profile of GH described in all cases less than 1 ng/ml for basal levels while maximum peaks were situated around 10-20 ng/mL.

. Sleep deprivation generally suppresses GH release, particularly after early adulthood.

Stimulators of growth hormone (GH) secretion include:

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