Dolophine Treatment: Administration, Interactions, and Side Effects

Dolophine is a FDA-approved medication used in the treatment of severe pain, as well as in the detoxification and maintenance treatment of opioid dependence.

Dolophine is a brand name medication containing the active ingredient methadone hydrochloride. Dolophine is used in the treatment of severe pain or in the maintenance treatment of opioid dependence as part of a comprehensive treatment program alongside appropriate social support and medical services.

What Is Dolophine?

Dolophine (methadone hydrochloride) is an opioid agonist. As an agonist, it turns on opioid receptors in the brain. Dolophine activates the body’s natural opioid system, decreasing the perception of pain. Dolophine also helps reduce the craving and withdrawal symptoms associated with heavy opioid use.

FDA Approved Uses

Initially approved by the U.S. Food and Drug Administration in 1947, Dolophine has been used for many years.

Currently, Dolophine is approved for the treatment of:

• Severe pain
• Opioid abuse detoxification
• Maintenance treatment of opiate dependence

Dolophine Prescribing Information

Dolophine can only be dispensed via specialized treatment programs, certified by the Substance Abuse and Mental Health Services Administration. Newly prescribed patients should be monitored closely for respiratory depression. Attention should be paid most closely to the first 24–72 hours of initiating therapy. Seek emergency help immediately if excess Dolophine is consumed. Never give anyone your Dolophine. Keep the medication away from children.

Did you know?

Many insurance companies will cover the cost of treatment for drug and alcohol addiction. Verify your insurance benefits with The Recovery Village Palm Beach at Baptist Health.

Dolophine Use in Opioid Withdrawal Treatment

Many studies have demonstrated the beneficial use of methadone in treating opioid dependence. One study showed methadone was overall superior to buprenorphine in maintaining abstinence and equally effective in decreasing opioid use.

See Related: Methadose vs Methadone

Dolophine Dosage

Dolophine tablets are available in 5mg and 10mg formulations. The dosing schedule depends on the particular condition and individual being treated. Always discuss specific dosing regimens with your healthcare provider.

Dolophine Side Effects

Methadone, the active ingredient in Dolophine, has undergone significant safety assessment since its initial approval in 1947. Long-term methadone maintenance therapy is a safe treatment option for people struggling with opioid dependence.

Some individuals may experience minor side effects, most pronounced during the initial adjustment phase.

Some of the most common side effects of Dolophine are:

• Lightheadedness
• Dizziness
• Sedation
• Nausea
• Vomiting
• Sweating
• Constipation
• Abdominal pain

More serious side effects of Dolophine use may include:

• Respiratory depression
• Systemic hypotension (significantly low blood pressure)
• Cardiac arrest
• Dependence and addiction

Risks

Methadone is a Schedule II controlled substance. Dolophine carries the risk of addiction, abuse and misuse. The long-acting mechanism of Dolophine further increases the risk of overdose and death.

• Overdose
  Life-threatening respiratory depression may occur as a result of using Dolophine inappropriately or incorrectly. The respiratory depressant effect of methadone starts much later and lasts much longer than the pain-relieving properties. This is important in those taking repeated doses. People taking the medication should allow for a minimum of six to eight hours between each dose. Always be aware of the potential for overdose with this medication.  
• Dependence
  The specific risk of developing dependence while taking Dolophine is unknown and varies from person to person. Dolophine should be taken with caution, because even patients taking the medication appropriately may become dependent.  
• Neonatal Opioid Withdrawal
  The development of neonatal opioid withdrawal as a result of methadone use during pregnancy is well-documented. Regular use of Dolophine during pregnancy is associated with newborn withdrawal symptoms upon delivery. This is a potentially life-threatening condition that must be dealt with accordingly and addressed by certified health care providers.      
• Life-threatening QT Prolongation
  There have been cases of serious heart arrhythmia described in people who use methadone. Known as QT interval prolongation or Torsades de Pointes, follow-up studies have confirmed the ability of methadone to inhibit cardiac ion channels, affecting their ability to pump correctly. The QT abnormalities were most often observed at high methadone concentrations.  
• Seizures
  Dolophine may increase the frequency of seizures in patients with a previous history of seizure disorder. Individuals with a known seizure disorder taking Dolophine should be monitored closely for any signs of worsening seizure activity.  
• Drug/Medication Interactions
  Methadone may interact with other medications. It is broken down by a set of enzymes (CYP enzymes) that are also responsible for the metabolism of many other medications. Speak with your healthcare provider about potential drug interactions. Some medications that may interact with Dolophine include: Monoamine oxidase inhibitors (MAOIs), such as hydralazine; Antiretroviral agents used in the treatment of HIV, such as zidovudine; Other opioid treatment medications, such as buprenorphine; Some heart medications that can affect the QT interval, such as verapamil; Benzodiazepines, such as lorazepam (Ativan); CYP enzyme modulators such as rifampin, carbamazepine, phenytoin, St. John’s wort or phenobarbital.  
• Other Precautions
  Those with any pulmonary diseases or severe asthma should exercise use increased caution if taking Dolophine due to the increased risk of respiratory depression. Dolophine may impair mental clarity, so it is recommended that patients taking Dolophine do not drive or operate heavy machinery. Do not drink alcohol while taking Dolophine — doing so may result in overdose or death.  

Dolophine and Pregnancy

The FDA categorizes methadone as a Category C pregnancy medication. Tell your health care provider if you become pregnant while taking Dolophine. Taking Dolophine while pregnant may cause significant harm to the developing baby. Additionally, the baby could be born with neonatal opioid withdrawal syndrome, a potentially lethal situation when not addressed correctly.

If a patient decides to continue taking methadone during pregnancy despite the risks, the dosage may need to be adjusted, as pregnancy may increase the clearance rate of the medication. Methadone should only be used during pregnancy if the potential benefit outweighs the potential risk of harm to the developing fetus.

Although methadone has been detected in human milk, the concentrations are minimal. It is now recommended that infants born to methadone-prescribed mothers should continue breastfeeding as per the usual guidelines. Infants of breastfeeding mothers taking Dolophine should be monitored closely. The benefits and risks associated with methadone use should be discussed with your health care provider.