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Old 08-04-2012, 12:32 PM   #1
tortoisegirl tortoisegirl is offline
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How often to take methadone

For anyone who has taken methadone: What dosing schedule works best for you? Times per day, and even or uneven doses.

I was on methadone previously for about three years, but never got ideal relief since my doctor had a dose limit for me of 70mg/day; he wouldn't increase my dose or try me on a different medication. To maximize my pain relief for work, I ended up only taking it twice a day, six hours apart in the morning (40mg & 30mg). I've spent the last few months switching to morphine, then fentanyl patches, at doses which should have been more than equivalent, but wasn't able to get even close to the methadone pain relief. Plus I was in withdrawal and had more side effects.

So, we started me back on methadone last week at 120mg/day. The doctor wrote it for 40mg three times a day. I quickly realized that I could no longer tolerate the 40mg at a time...it made me woozy, plus it wore off after a few hours. So, I have been trialing splitting it up, taking 20-30mg every 4 hours (so I'm still at/under 120mg/day).

I'm shocked that I only get about three hours of relief with it. Previously it was more like 5 hours. Pain levels are much improved from the last few months, and maybe slightly better than prior to that too. Maybe it will improve over time, such as when we do any titration. I read that every 6-8 hours seems to be the norm for methadone dosing. I know I am a fast metabolizer of pain meds, but it seems ridiculous that taking to take it every four hours, and even then, it takes an hour to kick in, two hours of relief, and then an hour to wait for the next dose.

Has anyone heard of a compounding pharmacy being able to make the methadone time delayed? I know as a medication it has a very very long half life, but its duration of pain relief is known to be short, especially for me. It seems to otherwise be the best med choice though. I know another option is a pain pump (since some doctors now use methadone in them), but I don't think I'm there just yet. Thanks! Best wishes.
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Kate
constant headache since 2006