I’m been on Methadone 80mg for 10-15 years due to medical condition/chronic pain
Originally short acting opioids….Percocet (Oxy 5mg / 325). Then….
Oxy-IR 5mg x 4
OxyContin 10mg x 2
Dilaudid 2mg x 4
Hydromorph-Contin 9mg x 2
Then finally Methadone 30mg…..increased to 80mg throughout a year or so until stable and chronic pain under control. Always taken in morning with breakfast 7am …..home at 3/4pm ish I take an additional 20mg if needed
Although Methadone has a very long half life of 24h approximately, it’s true analgesic “pain-killing” effects lasts only 6-10 hours depending on dose, liver enzyme (genetic makeup) DDI’s, fast or slow metabolizers or taking inhibitors/inducers/competitive substrates of same liver enzyme responsible for metabolizing Methadone hcl
In Germany, mostly Levo-Methadone is prescribed (40mg is equal to Racemic Methadone 80mg)
Methadone has a relatively fast onset of action and excellent oral bioavailability 80% and when taken for long term (chronic) is becomes more potent as it accumulates due to its long half life
Methadone 2.5-5mg would be very effective for an opioid naive patient (like Oxycodone 5mg & oral Morphine 10mg)
Methadone 80mg is a VERY effective dose for an opioid tolerant patient with long term chronic pain. You will not be able to use any other mu-agonist opioid medication while on Methadone…..as it’ll have zero effect.
Because hi-dose Methadone binds / occupies most of the mu-receptors in the CNS, taking a moderate to hi dose of Hydromorphone, Oxycodone, Diacetylmorphine, Oxymorphone, etc will be mostly useless and a waste……only thing that works is more Methadone lol, but be cautious while using other CNS depressants like benzodiazepines
Oxycodone is the most pleasurable, potent, effective, euphoric opioid analgesic if a short acting opioid is needed.
Methadone is an amazingly potent and effective long acting full mu-opioid receptor agonist. I like it