How to Use Methadone Safely
U.S. Department of Health & Human Services
Substance Abuse and Mental Health Services Administration
Food and Drug Administration
Methadone provides relief for patients who do not respond to
non-narcotic pain medicines and has also been used for decades to treat
individuals who suffer from addiction and dependence on heroin and narcotic
pain medicines. When taken as prescribed, methadone is safe and effective.
But all medicines have risks. Patients and healthcare providers need to
understand the power and physical effects of methadone in order to get the
A Proven Road to Relief—If You Keep Your Eyes on the Road
Whether known by Dolophine, Methadose or its generic name, methadone has
provided relief to millions of patients. Methadone works by changing how
the brain and nervous system respond to pain. It is also used in drug
detoxification and treatment programs to lessen the symptoms of withdrawal
and to block the effects of opiate drugs. Methadone allows individuals to
recover from their addiction and to reclaim active and meaningful
Patients being treated for pain generally receive a prescription from
their doctor and take the medication at home. Patients taking methadone for
addiction receive their doses at accredited programs under supervision.
After a period of stability, these patients are given methadone to take at
home between program visits. In all cases, if not taken correctly,
methadone can be dangerous.
The Dangers of Overdose
Pain relief from a dose of methadone lasts about four to eight hours.
But there are big differences in how each patient reacts to methadone. Even
after the pain relief effects wear off, methadone remains in the body for
much longer. Taking more methadone to relieve the pain can cause
Navigate the Risks: Two Simple Steps
1. Take Methadone exactly as prescribed.
To be safe, people must take only the dose prescribed, at the times
prescribed. Methadone can build up in the body to a toxic level if taken
too often, if the dose is too high, or if it is taken with certain other
medicines or supplements.
2. Know—and share—your complete health history.
People who take methadone need to give health professionals every detail
of what they are taking. This is especially important for a firsttime user
of methadone. A long list of medications can interact with methadone:
- Methadone may be more hazardous when used with alcohol, other opioids
(opium-like substances) or illicit drugs that depress the central nervous
- Be especially careful about other medicines that may make you sleepy,
such as other pain medicines, antidepressant medicines, sleeping pills,
anxiety medicines, antihistamines, or tranquilizers.
- Other medicines to watch out for include diuretics, antibiotics, heart
or blood pressure medication, HIV medicines and MAO inhibitors.
- If you are taking medicine that may cause disruptions in your heartbeat
(known as arrhythmias), you should be especially cautious taking
- Even if a medication is not on this list, it could still be
Older adults and people with debilitating conditions may be more
sensitive to methadone's effects. To avoid danger, people should tell
health professionals about any illnesses or conditions. Here are just a few
that doctors must know about:
- A history of drug or alcohol addiction
- Pregnancy and nursing (current or planned)
- Seizure disorders, such as epilepsy
- Cardiac conditions such as low blood pressure or long QT syndrome
- Breathing disorders such as asthma, sleep apnea or chronic obstructive
- Mental illness
- A history of head injury or brain tumors
- Other conditions, including liver or kidney disease, underactive
thyroid, curvature of the spine, gallbladder disease, adrenal gland
disorders such as Addison's disease, prostate enlargement and urination
Using Methadone: Steer Clear of Danger
What Can Patients Do to Stay Safe?
- Methadone can be addictive. Patients should take care not to abuse
- Never use more methadone than the amount prescribed.
- If you miss a dose or if you feel it is not working, do not take extra.
For pain management patients, take only the recommended dose at the
recommended time. For patients in methadone maintenance treatment for
addiction, contact your clinic for instructions.
- No one should use methadone if it has not been prescribed for
- Be especially careful if taking methadone for the first time.
When Taking Methadone:
- Do not consume alcohol or medicines that contain alcohol.
- Be careful when driving, operating heavy machinery or doing anything
that requires you to be alert. Methadone, like many other medications, can
slow thinking and reaction time and make you drowsy.
- Store methadone at room temperature and away from light.
- Always take methadone in the exact dosage amount and form you have been
- Take steps to prevent children from accidentally taking methadone.
- Never give methadone to anyone else even if the person has similar
symptoms or suffers from the same condition as you because it can be
- Dispose of unused methadone by flushing it down the toilet.
Suddenly stopping or going off methadone treatment can be dangerous.
Patients should talk to their doctors first. To minimize withdrawal
symptoms, health professionals can work out a plan to gradually reduce the
Take Side Effects Seriously
Some side effects are emergencies. Patients should stop taking
methadone—and contact a physician or emergency services right
- Have difficulty breathing or shallow breathing
- Feel light-headed or faint
- Get hives or a rash; have swelling of the face, lips, tongue or throat
- Feel chest pain
- Have a fast or pounding heartbeat
- Have hallucinations or confusion
Make sure your family members and members of your household know what
symptoms to look for, especially signs of shallow breathing or loud
Other side effects are not lifethreatening, but can still be cause for
concern. Patients should immediately talk to health professionals if they
have: severe or persistent nausea, vomiting, constipation, loss of
appetite, weight gain, stomach pain, sweating, mood changes, vision
problems, flush or red skin, sleep difficulties, decreased sexual desire or
ability or missed menstrual periods.
Feel Lost? Here's Help
Patients who develop a problem with methadone or have questions should
speak with a physician or contact 1-800-662-HELP.
Helpful information also can be found at the following Web sites:
U.S. Department of Health and Human Services (HHS)
Substance Abuse and Mental Health Services Administration (SAMHSA)
Center for Substance Abuse Treatment (CSAT)
CSAT's Division of Pharmacologic Therapies
Food and Drug Administration (FDA)