User:Mr. Ibrahem/Methadone

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"Metadon" redirects here. For the fly genus, see Metadon (fly).
Mr. Ibrahem/Methadone
The more active R enantiomer of methadone (levomethadone)
Clinical data
Trade namesDolophine, Methadose, others
AHFS/Drugs.comMonograph
MedlinePlusa682134
License data
Pregnancy
category
  • AU: C
Addiction
liability		High[1]
Routes of
administration		By mouth, intravenous, insufflation, sublingual, rectal
Drug classOpioid
Legal status
Legal status
Pharmacokinetic data
Bioavailability15-20% subcutaneous[2]

100% intravenous[2]

41–99% (by mouth)[2]
Protein binding85–90%[2]
MetabolismLiver (CYP3A4, CYP2B6 and CYP2D6-mediated)[2][4]
Onset of actionRapid[3]
Elimination half-life15 to 55 hours[4]
Duration of actionSingle dose: 4–8 h
Prolonged use:
• Withdrawal prevention: 1–2 days[3]
• Pain relief: 8–12 hours[3][5]
ExcretionUrine, faeces[4]
Identifiers
  • (RS)-6-(dimethylamino)-4,4-diphenylheptan-3-one
Chemical and physical data
FormulaC21H27NO
Molar mass309.453 g·mol−1
3D model (JSmol)
ChiralityRacemic mixture
  • CCC(C(C1=CC=CC=C1)(C2=CC=CC=C2)CC(N(C)C)C)=O
  • InChI=1S/C21H27NO/c1-5-20(23)21(16-17(2)22(3)4,18-12-8-6-9-13-18)19-14-10-7-11-15-19/h6-15,17H,5,16H2,1-4H3 checkY
  • Key:USSIQXCVUWKGNF-UHFFFAOYSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Methadone, sold under the brand name Dolophine among others, is an opioid used for opioid maintenance therapy in opioid dependence and for chronic pain management.[3] Detoxification using methadone can be accomplished in less than a month, or it may be done gradually over as long as six months.[3] While a single dose has a rapid effect, maximum effect can take up to five days of use.[3] The pain-relieving effects last about six hours after a single dose.[3][7] After long-term use, in people with normal liver function, effects last 8 to 36 hours.[3][5] Methadone is usually taken by mouth and rarely by injection into a muscle or vein.[3]

Side effects are similar to those of other opioids.[3] These frequently includes dizziness, sleepiness, vomiting, and sweating.[3] Serious risks include opioid abuse and a decreased effort to breathe.[3] Abnormal heart rhythms may also occur due to a prolonged QT interval.[3] The number of deaths in the United States involving methadone poisoning declined from 4,418 in 2011[8] to 3,300 in 2015.[9] Risks are greater with higher doses.[10] Methadone is made by chemical synthesis and acts on opioid receptors.[3]

Methadone was developed in Germany around 1937 to 1939 by Gustav Ehrhart and Max Bockmühl.[11][12] It was approved for use in the United States in 1947.[3] It is on the World Health Organization's List of Essential Medicines.[13] In 2013, about 41,400 kilograms were manufactured globally.[14] It is regulated similarly to other narcotic drugs.[15] It is not particularly expensive in the United States.[16]

References[edit]

  1. ^ Bonewit-West, Kathy; Hunt, Sue A.; Applegate, Edith (2012). Today's Medical Assistant: Clinical and Administrative Procedures. Elsevier Health Sciences. p. 571. ISBN 9781455701506. Archived from the original on 28 July 2020. Retrieved 2 August 2020.
  2. ^ a b c d e Anaheim, OM; Moksnes, K; Borchgrevink, PC; Kaasa, S; Dale, O (August 2008). "Clinical pharmacology of methadone for pain". Acta Anaesthesiologica Scandinavica. 52 (7): 879–89. doi:10.1111/j.1399-6576.2008.01597.x. PMID 18331375.
  3. ^ a b c d e f g h i j k l m n o p q "Methadone Hydrochloride". The American Society of Health-System Pharmacists. Archived from the original on 23 December 2015. Retrieved 22 December 2015.
  4. ^ a b c Brown, R; Kraus, C; Fleming, M; Reddy, S (November 2004). "Methadone: applied pharmacology and use as adjunctive treatment in chronic pain" (PDF). Postgraduate Medical Journal. 80 (949): 654–9. doi:10.1136/pgmj.2004.022988. PMC 1743125. PMID 15537850. Archived (PDF) from the original on 2014-05-02.
  5. ^ a b Toombs, JD; Kral, LA (1 April 2005). "Methadone treatment for pain states". American Family Physician. 71 (7): 1353–8. PMID 15832538. Archived from the original on 5 September 2017.
  6. ^ "WHOCC - ATC/DDD Index". www.whocc.no. Archived from the original on 28 July 2020. Retrieved 22 September 2020.
  7. ^ Grissinger, Matthew (August 2011). "Keeping Patients Safe From Methadone Overdoses". Pharmacy and Therapeutics. 36 (8): 462–466. PMC 3171821. PMID 21935293.
  8. ^ "Data table for Figure 1. Age-adjusted drug-poisoning and opioid-analgesic poisoning death rates: United States, 1999–2011" (PDF). CDC. Archived (PDF) from the original on 23 November 2015. Retrieved 22 December 2015.
  9. ^ Rudd, Rose A.; Seth, Puja; David, Felicita; Scholl, Lawrence (2016). "Increases in Drug and Opioid-Involved Overdose Deaths — United States, 2010–2015". MMWR. Morbidity and Mortality Weekly Report. 65 (5051): 1445–1452. doi:10.15585/mmwr.mm655051e1. ISSN 0149-2195. PMID 28033313.
  10. ^ Chou, R; Turner, JA; Devine, EB; Hansen, RN; Sullivan, SD; Blazina, I; Dana, T; Bougatsos, C; Deyo, RA (17 February 2015). "The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop". Annals of Internal Medicine. 162 (4): 276–86. doi:10.7326/M14-2559. PMID 25581257.
  11. ^ Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction. CRC Press. 2003. p. 13. ISBN 9780203633090. Archived from the original on 2015-12-23.
  12. ^ Kleiman, Mark A. R.; Hawdon, James E. (2011). "Diphenypropylamine Derivatives". Encyclopedia of Drug Policy. ISBN 9781506338248. Archived from the original on 2015-12-23.
  13. ^ World Health Organization (2019). World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. hdl:10665/325771. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
  14. ^ Narcotic Drugs 2014 (PDF). International Narcotics Control Board. 2015. p. 21. ISBN 9789210481571. Archived (PDF) from the original on 2015-06-02.
  15. ^ World Health Organization (2009). Guidelines for the psychosocially assisted pharmacological treatment of opioid dependence. World Health Organization (WHO). p. 78. hdl:10665/43948. ISBN 9789241547543.
  16. ^ Hamilton, Richart (2015). Tarascon Pocket Pharmacopoeia 2015 Deluxe Lab-Coat Edition. Jones & Bartlett Learning. p. 13. ISBN 9781284057560.
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