Generic Name:

Methadone

Trade Name:

Indications:

Analgesia
Sedation

Administration Guidelines

Usual Dosage Range and Route:

Analgesia/Sedation:

SLOW IV INJECTION: up to 20mg over at least 2 minutes

*loading dose is usually given prior to starting maintenance*

MAINTENANCE: 5- 25 mg/hr titrated to patient's response

Standard Concentrations:

50mg/50 ml (1mg/ml)

500mg /50 ml (10mg/ml)

MICROINFUSION:

50mg/50 ml (1mg/ml)

500mg/50ml (10mg/ml)

Vial:

5mg /5mL (1mg/mL)  

Special Considerations:

-Slow titration and frequent monitoring is recommended. (Refer to Intravenous Methadone Policy: Patient Monitoring )

- Rapid injection can cause increased side effects

- Tolerance may result in higher dosage requirements

- Accumulation can occur 36-48 hours after initiation of dosing, necessitating dosage/interval adjustment

-EKG evaluation is recommended in patients with potential QT prolongation from conduction abnormalities, drug interactions, electrolyte abnormalities, and/or high doses of methadone.

- For patients maintained on oral methadone and unable to tolerate oral therapy may convert (2:1) oral to IV therapy and consider consulting Addition Services for appropriate management recommendations.

-A stimulant laxative bowel regimen should be started for all patients receiving Methadone.

Precautions and Side Effects:

- Respiratory depression, bradypnea

- Bronchospasm, tachypnea

- Ileus, constipation, nausea, vomiting

- Hypotension

- CNS depression

- Tachycardia, Bradycardia

Subject :

Adult Critical Care Guidelines

Title:

Methadone

Approved By and Date:

Critical Care Committee 03/2009

MESAC 2/09

Reviewed By and Date:

Critical Care Committee 04/2008