DOLOPHINE PRESCRIBING INFORMATION PDF

Substances Authority for information on how to prevent and detect abuse or diversion of this product. Interactions with other CNS Depressants. Medscape – Detoxification, pain-specific dosing for Methadose, Dolophine opioids; Substantial interpatient variability, see prescribing information for guidance. Find patient medical information for Dolophine Oral on WebMD including its uses , side effects and safety, interactions, pictures, warnings and user ratings.

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For the relief of severe, chronic pain in opioid-tolerant patients, convert the current total daily dose of all opioids to an oral morphine equivalent dose, then multiply the morphine equivalent dose dolophlne the corresponding percentage in the dose conversion table provided in the FDA-approved labeling.

Patients should seek immediate medical attention if they experience symptoms such as nausea, vomiting, loss of appetite, fatigue, weakness, dizziness, or hypotension.

Safety and efficacy in pediatric patients have not been established; however, methadone is used off-label in these populations. Insoluble excipients will be present prescribinv tablets are dissolved; they will not completely dissolve.

Decreased respiratory drive and hypoventilation can cause carbon dioxide CO2 retention which can further increase intracranial pressure. Pregnant women in methadone maintenance programs may have reduced incidence of obstetric and fetal complications and neonatal morbidity and mortality when compared to women informatioon illicit drugs.

Opioid withdrawal symptoms have been associated with an increased risk of relapse to illicit drug use.

Methadone Dolophine, Methadose – Treatment – Hepatitis C Online

Methadone should be reserved for patients in whom alternative treatment options e. Careful monitoring is also required with concomitant use of drugs that may inhibit or induce the metabolism of methadone; an increase in methadone concentrations could cause potentially fatal respiratory depression.

Intravenous, Subcutaneous, or Intramuscular dosage. Infants born to narcotic-addicted women treated with methadone during pregnancy have been found to have decreased fetal growth with reduced birth weight, length, or head circumference. The safety, effectiveness, and pharmacokinetics of methadone in pediatric patients below the age of 18 years have not been established.

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Patients previously prescribed methadone who have not taken opioids for 1 to 2 weeks should be considered opioid-naive for the purposes of methadone reinitiation.

Methadone use is preferable to the use of illegal street drugs. Geriatric or debilitated patients are more susceptible to adverse reactions, especially sedation and respiratory depression, probably as a result of altered distribution of the drug or decreased elimination.

Additionally, avoid coadministration with other CNS depressants when possible as this significantly increases the risk for respiratory depression, low blood pressure, and death. Methadone dolophinf significantly decrease respiratory drive and cause hypoventilation. Because concentrates may numb the mouth or upset the stomach, it may be preferable to mix in 3—4 ounces 90— ml of liquid e. The total daily oral dose on Day 1 should not ordinarily exceed 40 mg.

The potential risk of serious adverse effects with concomitant use of methadone and other CNS depressants should not preclude the appropriate treatment of opioid addiction with methadone, but requires more intensive counseling and monitoring.

If possible, opiate agonists should not be given until the toxic substance has been eliminated. Although opiate agonists are contraindicated for use in patients with diarrhea secondary to poisoning or infectious diarrhea, antimotility agents have been used successfully in these patients. Stir well and have patient drink all of the dosage dispersed.

Respiratory depression may persist for a significant period of time after discontinuation of methadone and patients require close monitoring until their respiratory rate has stabilized. Methadone should be avoided in patients treated with monoamine oxidase inhibitor therapy MAOI therapydue to the potential risk for serotonin syndrome. Local tissue reactions may occur with SC use. If clinically indicated, patients may be enrolled directly into a maintenance program without first attempting detoxification since the purpose of the maintenance program is to provide a stable dose of methadone as a substitute for illicit opiate use.

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In addition to slowing the rate of cardiac repolarization thus lengthening the QT interval, methadone may produce cholinergic side effects by stimulating medullary vagal nuclei causing bradycardia and induce the release of histamine causing peripheral vasodilation. If patients experience breakthrough pain, dose adjustment or a small rescue dose of an immediate-release analgesic should be considered.

Medical withdrawal of methadone maintenance is generally not recommended during pregnancy. Angina, bradycardia, cardiac arrhythmias, cardiac disease, coronary artery disease, diabetes mellitus, females, heart failure, hypertension, hypocalcemia, hypokalemia, hypomagnesemia, hypotension, hypovolemia, long QT syndrome, malnutrition, myocardial infarction, orthostatic hypotension, QT prolongation, thyroid disease.

In addition, the initiation of longer-acting opioids, such as methadone, is not recommended unless shorter-acting opioids have been unsuccessful, or titration of shorter-acting doses has established a clear daily dose of opioid analgesic that can be provided by using a long-acting form.

Benefits of methadone therapy during pregnancy include assisting women staying free of heroin or other opioids, increasing prenatal care, lessening the possibility of fetal death, and reducing the risk of HIV and hepatitis infection.

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The prescrlbing of methadone in maintenance treatment is limited to the control of opiate withdrawal symptoms and is not effective in the treatment of anxiety. Local tissue reactions may occur with IM use. When the patient no longer requires methadone, taper the dose gradually every 2 to 4 days to prevent withdrawal in the physically-dependent patient.

If concurrent use is necessary, use the lowest effective doses and minimum treatment durations possible and monitor patients closely for signs and symptoms of respiratory depression and sedation.

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