What Is Methadone?
Methadone is a medication used in medication-assisted treatment (MAT) to help people reduce or quit their use of heroin or other opiates. Methadone has been used for decades to treat people who are addicted to heroin and narcotic pain medicines. When taken as prescribed, it is safe and effective. It allows people to recover from their addiction and to reclaim active and meaningful lives. For optimal results, patients should also participate in a comprehensive medication-assisted treatment (MAT) program that includes counseling and social support.
Methadone works by changing how the brain and nervous system respond to pain. It lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic oioids like oxycodone and hydrocodone.
What is methadone used for?
Methadone is commonly used for the following conditions.
- Management of severe, chronic pain
- Detoxification from opioids in people with an opioid use disorder
- Maintenance of recovery in people with an opioid use disorder
Methadone may also be used for other conditions as determined by your healthcare provider.
How does methadone work (mechanism of action)?
Methadone works by activating opioid receptors. This produces an effect similar to other prescription opioids like morphine. Activating opioid receptors reduces the feeling of pain in the body.
How is methadone supplied (dosage forms)?
Brands and other names
- Diskets
- Dolophine
- Methadose
Dosage forms and strengths
- 10 mg/mL oral concentrate
- 5 mg/5 mL, 10 mg/5 mL oral solution
- 5 mg, 10 mg oral tablets
- 40 mg dispersible tablets for oral suspension
Methadone is also available in injectable forms.
How should I store methadone?
Methadone should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place.
Side Effects
What are the most common side effects of methadone?
The most common side effects of methadone are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Lightheadedness or dizziness
- Sleepiness or tiredness
- Nausea or vomiting
- Sweating
- Constipation
- Headache
- Stomach pain
There may be other side effects of methadone that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of methadone?
While less common, the most serious side effects of methadone are described below, along with what to do if they happen.
Severe Allergic Reactions. Methadone may cause allergic reactions, which can be serious. Stop taking methadone and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Increased Pain and Pain Sensitivity.
 Methadone may cause allodnia, which is when you have pain from something that normally does not cause pain such as brushing your hair. Methadone may also cause opioid induced hyperalgesia, which is when something that causes pain can make you feel more intense pain. Contact your healthcare provider right away if you have pain from things that did not cause pain before or an increase in pain intensity. It is very important to not take more methadone if your pain feels worse, as this may cause significant breathing problems.
Breathing Problems.
 Methadone may cause slow or shallow breathing, especially if you have breathing problems from another condition like asthma or chronic obstructive pulmonary disease (COPD) or take other medicines that can slow your breathing. Tell your healthcare provider if you develop severe sleepiness or trouble breathing, especially when you start methadone or when your dose is increased. Get emergency help if you have any of the following symptoms.
- Changes in the color of your skin, including bluish color to your lips and fingernails
- Confusion
- Shortness of breath
- Feeling dizzy, lightheaded, or fainting
- Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
- Slow or shallow breathing
- Excessive sleepiness or trouble staying awake
Risk of Misuse and Addiction.Â
Misusing methadone can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take methadone exactly as prescribed. Tell your healthcare provider if you feel that methadone is not working. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.
- Sudden confusion or feeling disoriented
- Feeling paranoid
- Suicidal thoughts or actions
- Seizures
- Trouble breathing
Heart Rhythm Changes. Methadone may cause a rare, dangerous heart rhythm problem called QT prolongation and torsade de pointes. Some people have a higher risk of this, including people who are older, have other people in their family who have had these conditions, have low potassium or magnesium levels, or who take medicines that can prolong the QT interval. Tell your healthcare provider right away if you faint or have changes in your heart rate or rhythm, such as a fast or skipping heartbeat.
Serotonin Syndrome.
 Serotonin syndrome is when there is too much of a substance called serotonin in your body. Methadone can cause serotonin syndrome when it is taken with other medicines that affect serotonin. This condition can be life-threatening. Tell your healthcare provider about all medicines you take before taking any new medicine, including methadone. Get emergency help if you have any of the following symptoms of serotonin syndrome.
- Sweating, fever, or flushing
- Confusion
- Feeling agitated or restless
- Seeing or hearing unusual things
- Dizziness
- Fast or racing heartbeat
- Nausea, vomiting, or diarrhea
- Muscle twitching, stiffness, or tremor
- Seizures
Reduced Adrenal Function.
 Long-term use of methadone can cause your body’s adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency.
- Nausea and vomiting
- Weakness, tiredness, or lack of energy
- Low blood pressure
Low Blood Pressure (Hypotension).Â
Methadone may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Confusion
- Feeling weak or tired
Seizures. Methadone may cause seizures, especially if you have a seizure disorder. There are many different types of seizures and some of them are not easy to recognize. Stop taking methadone and call your healthcare provider if you have any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Low Blood Sugar (Hypoglycemia).
Methadone can cause low blood sugar, which can be serious and may lead to death. You may need to check your blood sugar more often if you have changes to your diet, exercise regimen, or medicines for diabetes. Do not use methadone and call your healthcare provider right away if you have any of the following symptoms of hypoglycemia.
- Headache
- Crankiness or anxiety
- Hunger
- Dizziness or confusion
- Blurry vision
- Slurred speech
- Sweating
- Feeling jittery or shakiness
- Fast heartbeat
- Seizures
Warnings & Precautions
Who should not use methadone?
Allergies to Ingredients. People who are allergic to any of the following should not take methadone.
- Methadone
- Dolophine
- Diskets
- Methadose
Your pharmacist can tell you all of the ingredients in the specific methadone products they stock.
Lung problems. Methadone should not be used if you have severe asthma, trouble breathing, or other lung problems. Methadone can make these conditions worse.
Gut Blockage. Methadone should not be used if you have a blockage of your gut (bowel obstruction) or a narrowing of the stomach or intestines. Methadone can make these conditions worse.
Slowed Gut Movement. Paralytic ileus is a type of ileus where your intestines are unable to move food through them. Methadone can make this condition worse.
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