Methadone Information for Hospice Patients
What is methadone?
Methadone is an opioid pain reliever that is helpful for pain that is in the medium to severe range. It works in the body in ways like
morphine and oxycodone do, but also in different ways that benefit some people. The hospice / palliative care team as experts in managing
pain have found it to help when other medications fail, and to offer relief from pain that isn't relieved by other opioids. It is also used for
breathlessness (air hunger) and sometimes for anxiety or agitation when there are signs of underlying pain.
What are the benefits of using methadone?
 Methadone is often more effective than other opioids for neuropathic pain, a type of pain caused by nerve damage that can be
more challenging to manage)
 Methadone is long acting, so it can usually be given in only two or three doses each day.
 A liquid version is available for patients who cannot swallow pills. It may also be given rectally.
 Doses are easily adjusted by small amounts.
 Methadone is generally well tolerated and tends to cause less constipation and nausea than other opioids.
 Methadone doesn’t have toxic breakdown products (metabolites) like most other opioids.
 Methadone may be safer than other pain medications if liver or kidney problems are present.
What is the experience with methadone in Hospice and palliative Care?
 Hospice and palliative Care teams include physicians and pharmacists with knowledge in dosing methadone safely and effectively,
assuring that dangerous conditions or interactions are avoided or greatly reduced.
 Methadone has been used in many palliative care and hospice patients without serious problems when taken as directed.
 Methadone is carefully watched in palliative care and hospice patients and established protocols are followed. We screen patients
for medical issues and other drugs that might interact with methadone.
Important information about methadone:
 Follow all dosing instructions carefully.
 Like other opiate medicines, methadone can slow your breathing and be sedating.
 Never use more methadone than your hospice team has prescribed.
 You will be prescribed a different medication, usually morphine, hydromorphone or oxycodone, for breakthrough pain, pain that
“breaks through” your normal level of pain control. Your team will help you keep a log of when you take breakthrough pain
medication, including the exact time, your pain scale rating (zero-10), and the dose that relieves your pain so that your palliative
care team can assure that your methadone dose is at the correct level.
 Call your hospice nurse if you think the medicine is not working or is causing side effects.
 Do not stop using methadone suddenly or you could have withdrawal symptoms.
 Call your hospice nurse if you miss doses or forget to take this medication.
 Avoid alcohol while you are taking methadone.
 Inform all other caregivers (doctors, dentists, pharmacies) that you are receiving methadone.
 Inform your hospice nurse of all other medications, herbs and supplements that you are taking, including recreational drugs.
 Side effects from methadone may impair your thinking, reaction time and ability to safely drive or operate machinery.
 Never give your methadone to another person. A dose of methadone that is appropriate for a particular patient could be
harmful or fatal to another person.
 Keep your medication in a secure place where others cannot get to it.
 Be sure to tell your nurse if you are allergic to any pain medications or opioids.
 Methadone may not be appropriate for some patients who have been diagnosed with an abnormal heart beat or arrhythmia, or who
are taking certain medications that can affect the heart rhythm. Inform your nurse of all other medications.
Warning with methadone:
Please discuss any concerns that you may have about methadone with your palliative Care team. Your team will do everything to
ensure that you are carefully treated and watched to minimize any risk from this medication.
Why was methadone chosen for me?
The use of any medication is a combined effort between you, your palliative care team, your family and caregivers. We believe
this medication is the best choice for you and your condition. Your team at hospice wants you to be comfortable and for you to
enjoy every day. In selecting this medication, we hope your discomfort will lessen and your quality of life will improve.
Credit: Dr. Paul Johnson,
Hospice of the Northwest