Methadone information sheet

Methadone is available as liquid, tablets, and injections (into the vein or under the skin). 

Our team will discuss which formulation is best for your child. Your child may be on other opioids to manage their symptoms. 

Methadone can be used in combination with other opioid medicines.  
 

The dose needed is very individual. Some children need more than others. 

• The correct dose is the amount that eases your child's symptoms. 
• Your doctor will work out a safe starting dose, which may need to be increased or decreased.
• So that your child achieves the best possible symptom control, with the least side effects, any changes will be monitored carefully by our team. 
• There is no maximum dose of methodone, however if your child continues to need increased doses, they may not be on the right medicine for them and we may consider changing to a different medicine. 
• Your child's body may get used to a certain dose of methodone and the dose may need to be increased over time. This is called 'tolerance'. 
• A dose increase does not necessarily mean your child's condition is getting worse and does not mean that they are becoming addicted. 

Methadone may cause the following unwanted side effects. 

Not everybody experiences side effects and it is important to remember these are not an allergic reaction, and are often temporary and manageable. If your child experiences any of these, please inform us.  

• constipation 
• nausea and vomiting 
• drowsiness 
• itch

The following side effects are rare, but may need medical attention: 

• seizures
• heart palpitations or altered heart rate
• restlessness
• agitation
• sweating. 

Contact us or your child’s primary care team for advice if your child develops these. 

In some cases, your doctor may suggest your child has an ECG (an investigation to check heart rate) before starting methadone. However, this is not usually necessary as altered heart rate is a very rare side effect of methadone, and is especially rare in the low doses used for children. 

If your child stops taking methadone suddenly this may cause them to become unwell. 

Please speak to your doctor if you have any concerns. 

Methadone may interact with other medicines or increase risk of side effects. 

It is important you tell us of all medicines, vitamins, herbs and other complementary medicines your child is taking. 

Your doctor and pharmacist will monitor these interactions.

To ensure safe use of this medication, please:

• be familiar with your child’s medicine including the name, brand, strength and dose. It is a good idea to have this information written down 
• store your child’s medicine in a safe place, out of reach of children, pets and vulnerable people. Ensure it is out of direct sunlight and not near heat sources like heaters  
• measure your child’s doses carefully and accurately 
• know how to give your child’s medicine, for example, know if a tablet can be crushed, or if a liquid can be mixed with another substance 
• give your child’s medicines at times prescribed. Setting up reminders may help  
• record when you have given medicines to your child 
• record the effects of medicines, especially any side effects or unusual reactions, and tell your child’s doctor 
• know what to do if you forget to give your child a dose, for example, whether you give it when you remember or wait until the next scheduled dose? NB. Never double a dose to make up for a missed dose 
• do not intentionally miss or change your child’s medicines without telling your doctor
  ensure you always have adequate supply of medicines so you never run out, particularly over weekends or public holidays
• return any unused, unwanted or expired medicines to any pharmacy for appropriate disposal. Do not put medicines in the bin or down the drain.

Pain medicines will not stop your child’s health care team or you from monitoring the progress of your child’s illness. 

There are other signs and symptoms of progression that can be observed.
 

Pain is better controlled when managed early. Your child’s pain may be more difficult to control if left too long without treatment. 
 

Methadone and other opioids are not addictive when given appropriately (i.e: at a safe dose and for the right reasons). Methadone and other opioids may be addictive when used for incorrect purposes. 

Methadone can be used as a treatment for opioid dependence / addiction. 

However, it is also a safe and effective medicine for pain, and is usually needed in much lower doses for pain management compared to doses required for treatment of opioid dependence / addiction. 
 

When methadone is used safely and appropriately, it does not have a significant effect on breathing. 

Relieving your child’s pain changes their quality of life, but will not shorten its length.