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Methadone update

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Posted 4/16/2016 3:00 AM (GMT 0)
For those that read my previous post about 5-6 weeks ago, methadone has been life changing for me. My doc started me on 2.5 mg bid and has slowly titrated my dose up based on my symptoms. I'm now on 10 mg morning and night and 5 mg in the afternoon. Some days I have zero pain, other days it's enough pain that I don't want to be on my feet but those days are far less than before. I'm returning to work this Monday and I'm so grateful. I love my job but haven't enjoyed it because of my neuropathy and being on my feet all day. I haven't felt this good in almost 2 years. I also have ulcerative colitis and am doing well with that. I feel like I'm getting my old self back and I love it.
Posted 4/16/2016 4:28 AM (GMT 0)
That's great! I'm so glad that you have found a med that works. I hope you feel better and better:)
Posted 4/16/2016 7:32 AM (GMT 0)
Yours is an uplifting post. Thank you for sharing.

It is heartwarming to read that you are feeling like yourself and finding much needed respite from pain. I hope that the positive trend continues for you.
- Karen -
Posted 4/16/2016 10:29 AM (GMT 0)
If your Dr has not followed these safety guidelines for use of methadone in chronic pain please inquire about them and request that he does.

Baseline Electrocardiograms- On the controversial key topic of baseline ECGs,the panel has two strong recommendations,both based on low quality evidence.

·Obtain an ECG before starting methadone in patients with risk factors for QTc interval prolongation,any previous ECG showing a QTc>450 ms,or a history suggesting previous ventricular arrhythmia. In patients without new risk factors for QTc interval prolongation,an ECG within the last 3 months with a QTC<450 ms can serve as a baseline study.

In contrast,some previous guidelines required a baseline ECG screening for all patients.
·The panel recommends against methadone use in patients with a baseline QTc interval>500ms

Some previous guidelines allowed methadone use in selected patients in this category.

Panelists provided a lengthy discussion of EGGs and risk factors for TdP and for QTC interval prolongation.


Monitoring and follow-up ECGs

Three strong recommendations for follow-up ECGs,all with low- quality evidence.

· Base follow-up ECGs on baseline ECG findings,methadone dose changes,other risk factors for QTc interval prolongation.

· Switch patients with QTc interval >500 ms to a different opioid,or immediately lower the methadone dose;evaluate and correct reversible QTc interval prolongation;repeat the ECG after lowering the dose.

· In patients with a QTc interval>450ms but<500ms,consider switching to an alternative opioid or lowering the dose(otherwise,discuss with the patient the potential risks of continuing methadone therapy) evaluate and correct any reversible causes of QTc; repeat the ECG after lowering the dose.

Thats all I'm going to say.
Posted 4/16/2016 12:34 PM (GMT 0)
Hey platinumpixie.

Glad it's working for you.Take as directed.

I only took methadone for a few months so I'm definitely not very experienced with it.I do know that it was very effective for pain.

You can tell it's gets a reaction that other pain meds don't.

Vickie knows about it from her experience taking it,prescribed by a Doctor.She knows a lot more about it than I,so I take her word for it.

Not trying to alarm you.Probably Millions of success stories with patients taking methadone.I've never investigated.

I was taking Dilaudid at a previous PMD.so,the only thing stronger would have been more of it.

There are risks with all opiate pain meds.

But the Headline,is that your pain levels are down and you're participating in life again.That's a success story.

Keep us posted.

Take care and God Bless.

Rick

Post Edited (tidalmouse) : 4/16/2016 6:42:49 AM (GMT-6)

Posted 4/16/2016 12:58 PM (GMT 0)
I agree with both responses above. Really glad your quality of life is improving. Also speaking from personal experience...be careful

Take care
Posted 4/21/2016 6:32 AM (GMT 0)
I personally thought methadone was the best med, with the long half life, it does not wear off, and it gives continuous pain relief. BUT my dr left town and the one I see now, does not use it. Was the hardest med to get off I ever had to do. I was switched to oxycontin, deinitely not my drug of choice. My pain dr. had told me that with methadone I could take it over the day at different intervals or I could take the entire 30mg at night. I chose to take it all at night. Got a wonderful nights sleep, and the med controlled the pain all day long, due to the long half life. The other wonderful thing about methadone is , of course, the low cost. I have seen people taking 180 mg or more two or more times a day. THe 30 I took worked well for me. I would love to go back to methadone, but would not do so unless I was promised that I would not have to go thru withdrawal from it again. I do know that they will be doing serial ekgs for you, to monitor your heart. best of luck to you.
Posted 4/23/2016 9:13 PM (GMT 0)
Some of you know that I am currently tapering off methadone after using it as my main pain med for decades. It can be a harsh mistress giving with one hand and taking with the other. On 40mg/day I went back to school for a second career, graduated with a 4.0 gpa, landed a job my classmates envied and started back hiking and kayaking with my husband. I am still employed but....have lost most of my teeth, am a slave to my bowels and certainly do not want people I work with to know what I need to do everyday. I am tapering 5 mg a day each month and am down to 30mg a day from 40 mg/day. Not too many probs yet. I spread the dose out during the day. Once the methadone is gone the oxycodone is next.

I wish you the best and hope it gives you the relief to live your life like I have mine just please be careful. Would I do the same all over again? Initially yes but would have tapered off sooner.
Posted 4/25/2016 3:40 PM (GMT 0)
Thank you for all of the replies. Even though I chose to proceed with methadone, I'm still on high alert from the warnings from experienced methadone patients.
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