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.
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.
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.
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.