Update on the safe use of methadone for pain management in adults

摘要

Methadone is a synthetic opioid increasingly used for pain management, yet it can be challenging to use safely. The most serious and potentially fatal side effects of methadone are respiratory depression and cardiac arrhythmias. Preventing these side effects is of paramount importance to ensuring the safe use of methadone for pain management. The safe use of methadone is being guided by the US Food and Drug Administration (FDA), the Drug Enforcement Administration (DEA), the manufacturer of methadone (Roxane Laboratories, Inc., Columbus, OH, USA), the Institute for Safe Medication Practices (ISMP), and experts in the field of pain management. The purpose of this paper is to discuss actions taken by the FDA, DEA and the drug manufacturer and to review recommendations made by the ISMP and other experts for initiating, prescribing, dispensing, administering, and monitoring methadone in adults. The main emphasis is on translating practice recommendations into actions that healthcare practitioners should take to safeguard the use of methadone for pain management.