![]() Patients receiving other sedative drugs, including alcohol and benzodiazepines.Frail or elderly patients (decreased methadone clearance).Consider much lower initial doses in the following patients undergoing methadone treatment (e.g.Week 1:Ĭontinue slow titration if adequate analgesia still not achieved. Note: preferred titration doses and intervals are indicated by bold print. During methadone treatment, particular vigilance is necessary during treatment initiation, during conversion from one opioid to another, and during dose titration.” ( Source: black box warning – package insert) Protocol for Opioid-Naive Patients – ‘Start low, go Slow’: It is critical to understand the pharmacokinetics of methadone when converting patients from other opioids. “Deaths, cardiac and respiratory, have been reported during initiation and conversion of pain patients to methadone treatment from treatment with other opioid agonists. Methadone Treatment: Initiation and Titration
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