methadone

Adjunctive therapy

Brands: Methadose, Dolophine

Last reviewed 2025-12-30

Reviewed by PsychMed Editorial Team.

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Quick answers

What is methadone?
Methadone (brands include Methadose and Dolophine; generics) is a long-acting, full opioid agonist used for opioid use disorder (OUD) treatment (in regulated opioid treatment programs) and for analgesia (label).
What is Methadose?
Methadose is a brand name for methadone (other brands: Dolophine).
What is Methadose (methadone) used for?
Label indications include: Opioid use disorder maintenance in certified opioid treatment programs and analgesia (label varies by product).
What drug class is Methadose (methadone)?
Long-acting full μ-opioid receptor agonist used for opioid use disorder maintenance (in regulated opioid treatment programs) and for analgesia. Long and variable half-life can lead to accumulation and overdose risk if titration is too rapid (label/guideline).
What strengths does Methadose (methadone) come in?
Oral tablets and oral solutions (label; product-specific).

Snapshot

Class: Adjunctive therapy
Common US brands: Methadose, Dolophine
Therapeutic drug monitoring not routinely recommended.
Last reviewed: 2025-12-30

Label indications

Opioid use disorder maintenance in certified opioid treatment programs and analgesia (label varies by product).

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Clinical Highlights

Methadone (brands include Methadose and Dolophine; generics) is a long-acting, full opioid agonist used for opioid use disorder (OUD) treatment (in regulated opioid treatment programs) and for analgesia (label). In opioid use disorder care, methadone is associated with strong treatment retention and reduced illicit opioid use, but access is shaped by program requirements and early-treatment safety needs (guideline/clinical).

Methadone has a long and highly variable half-life, and the risk of accumulation is highest early in treatment because clinical effects can outlast perceived analgesia. This is one reason cautious titration and close early monitoring are emphasized in guidance (label/clinical).
QTc prolongation is a key safety consideration. Methadone is associated with torsades de pointes in some cases; clinical practice often includes baseline risk assessment and ECG planning when risk factors are present (label/clinical).
Sedation and respiratory depression risks increase when methadone is combined with alcohol, benzodiazepines, sedating sleep medications, or other opioids, making medication reconciliation and polysubstance risk review central to safe use (label/clinical).
The compare view, methadone evidence feed, and methadone print page support counseling when opioid treatment choices overlap with anxiety, insomnia, or co-prescribed sedatives.

Dosing & Formulations

Methadone is available as oral tablets and oral solutions; product formulations and indications vary (label). Opioid use disorder dosing is commonly managed within an opioid treatment program with structured follow-up. Dose changes are typically individualized to control withdrawal/cravings while minimizing sedation and accumulation risk (guideline/clinical).

Because of long half-life variability and interaction risks, many clinicians avoid rapid dose escalation and reassess frequently after medication changes (label/clinical).

Monitoring & Risks

Respiratory depression and opioid overdose risk is highest during initiation, after dose increases, and when combined with other sedatives. Overdose-risk counseling and review of co-prescribed CNS depressants is routine (label/clinical). QTc prolongation: ECG planning is often considered when patients have cardiac disease, electrolyte abnormalities, high doses, or co-use of other QT-prolonging drugs (label/clinical).

Sedation and cognitive impairment can affect driving and work safety, especially early in treatment (label/clinical).
Constipation, sweating, sexual dysfunction, and sleep disruption can occur; managing side effects can improve retention in long-term treatment programs (clinical).

Drug Interactions

Many CNS depressants increase sedation and respiratory depression risk, including alcohol, benzodiazepines, sedative-hypnotics, and gabapentinoids (label/clinical). CYP inducers or inhibitors can change methadone exposure and withdrawal control; regimen changes often prompt monitoring for withdrawal or over-sedation (label/clinical).

QT-prolonging medications and electrolyte disturbances can add risk; combined-risk review is common when polypharmacy is present (label/clinical).

Practice Notes

Choice among methadone, buprenorphine, and naltrexone is typically individualized by opioid tolerance, prior treatment response, access, and medical risk. Methadone is often favored when higher tolerance or prior non-response to buprenorphine is present (guideline/clinical). In psychiatric settings, methadone care frequently requires coordination to avoid overlapping sedatives and to monitor QTc risk when antipsychotics or other QT-active drugs are co-prescribed (clinical).

References

Methadone hydrochloride tablets prescribing information — DailyMed (2025)
The ASAM National Practice Guideline for the Treatment of Opioid Use Disorder: 2020 Focused Update — Journal of Addiction Medicine (2020)
TIP 63: Medications for Opioid Use Disorder — SAMHSA (2021)
Torsade DE Pointes Associated With Very High Dose Methadone — Annals of Internal Medicine (2002)