Alternate Name(s):
Metadol
Classification:
Analgesic, Narcotic
Original Date:
May 2009
Revised Date:
June 2011
Indications:
- Neonatal Narcotic Abstinence Syndrome
- Weaning from long-term narcotics: will facilitate wean from IV opioids to long acting oral opioids
Administration:
- PO
Dosage:
- Neonatal Narcotic Abstinence Syndrome: 0.05 - 0.2 mg/kg/dose Q12H or Q24H.
- Individualize dose and tapering schedule to control symptoms of withdrawal; usually taper dose by 10% to 20% per week over 1 to 1.5 months
- Analgesia (stepdown from IV opioids): 0.1 mg/kg/dose
- Dosing interval may range from Q4-12 H during initial therapy
- Decrease in dose or frequency may be required (approximately 2-5 days after initiation of therapy or dosage increase) due to accumulation with repeated doses
Side Effects:
- CNS: CNS depression, elevated intracranial pressure
- CVS: hypotension, bradycardia, peripheral vasolidation. prolongation of QT interval, torsade de pointes
- Endocrine and metabolic: antidiuretic hormone release
- Genitourinary: urinary tract spasm
- GI: ileus and delayed gastric emptying, constipation, xerostomia
- Ocular: miosis
- Respiratory: respiratory depression
Parameters to Monitor:
- Respiratory, cardiovascular and mental status
- Pain relief
- Abstinence scoring system (if used for neonatal abstinence syndrome)
Reconstitution and Stability:
N/A
Compatibility:
N/A
Notes:
**Restricted to physicians who have Methadone prescribing privileges per Health Canada
References:
-Taketomo CK, Hodding JH, Kraus DM. Pediatric Dosage Handbook 16th Edition. Hudson: Lexi-Comp Inc.; 2009
-Young TE, Mangum B. Neofax®. 20th edition. Raleigh: Acorn Publishing; 2007
-Zenck KE, Sills JH, Koeppel RM. Neonatal Medications & Nutrition, 3rd edition. Santa Rosa, California; NICU INK Book Publishers, USA, 2003