IV, IM, subcutaneously: 2.5 to 10 mg every 3 to 6 hours.
Usual Adult Dose for Opiate WithdrawalInitial Dose: 15 to 40 mg once a day. The oral route is preferred unless the patient is unable to ingest oral methadone, then parenteral form can be used. 5 to 10 mg additional doses may be given if symptoms of abstinence are distressing.
After one or two days, a 20% daily reduction in dose can usually be tolerated. Detoxification can usually be completed within 10 days.
Maintenance of opiate dependence: 20 to 120 mg/day.
Oral - Diskets:
The initial methadone dose should be administered, under supervision, when there are no signs of sedation or intoxication, and the patient shows symptoms of withdrawal.
Initial dose: a single dose of 20 to 30 mg of methadone will often be sufficient to suppress withdrawal symptoms. The initial dose should not exceed 30 mg.
If same day dosing adjustments are to be made, the patient should be asked to wait two to four hours for further evaluation, when peak levels have been reached. An additional 5 to 10 mg of methadone may be provided if withdrawal symptoms have not been suppressed or if symptoms reappear. The total daily dose of methadone on the first day of treatment should not ordinarily exceed 40 mg. Dose adjustments should be made over the first week of treatment based on control of withdrawal symptoms at the time of expected peak activity (e.g., 2 to 4 hours after dosing). Dose adjustment should be cautious; deaths have occurred in early treatment due to the cumulative effects of the first several days dosing. Because diskets can be administered only in 10 mg increments, diskets may not be the appropriate product for initial dosing in many patients. Patients should be reminded that the dose will "hold" for a longer period of time as tissue stores of methadone accumulate. Buy Methadone
Initial doses should be lower for patients whose tolerance is expected to be low at treatment entry. Loss of tolerance should be considered in any patient who has not taken opioids for more than five days. Initial doses should not be determined by previous treatment episodes or dollars spent per day on illicit drug use.
For Short-term Detoxification:
For patients preferring a brief course of stabilization followed by a period of medically supervised withdrawal, it is generally recommended that the patient be titrated to a total daily dose of about 40 mg in divided doses to achieve an adequate stabilizing level. Stabilization can be continued for 2 to 3 days, after which the dose of methadone should be gradually decreased. The rate at which methadone is decreased should be determined separately for each patient. The dose of methadone can be decreased on a daily basis or at two day intervals, but the amount of intake should remain sufficient to keep withdrawal symptoms at a tolerable level. In hospitalized patients, a daily reduction of 20% of the total daily dose may be tolerated. In ambulatory patients, a somewhat slower schedule may be needed. Because diskets can be administered only in 10 mg increments, diskets may not be the appropriate product for gradual dose reduction in many patients.
For Maintenance Treatment:
Patients in maintenance treatment should be titrated to a dose at which opioid symptoms are prevented for 24 hours, drug hunger or craving is reduced, the euphoric effects of self-administered opioids are blocked or attenuated, and the patient is tolerant to the sedative effects of methadone. Most commonly, clinical stability is achieved at doses between 80 to 120 mg/day.Buy Methadone
For Medically Supervised Withdrawal After a Period of Maintenance Treatment:
There is considerable variability in the appropriate rate of methadone taper in patients choosing medically supervised withdrawal from methadone treatment. It is generally suggested that dose reductions should be less than 10% of the established tolerance or maintenance dose, and that 10 to 14 day intervals should elapse between dose reductions. Because diskets can be administered only in 10 mg increments, it may not be the appropriate product for gradual dose reduction in many patients. Patients should be apprised of the high risk of relapse to illicit drug use associated with discontinuation of methadone maintenance treatment.