Methadone

Metabolism/Excretion
Hepatic, minimal renal excretion
Plasma Protein Binding %
 
60-90
 
Dose For Normal Renal Function
Oral = 0.05-0.2 mg/kg dose q4-6h for 3-4 doses, then q8-12h; IV = 0.03-0.1 mg/kg dose q4-6h for 3-4 doses, then q8-12h
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 30-50
q6-8h
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 10-29
q8-12h
Adjustment For Renal Function Gfr, Ml/Min/1.73M2 <10
q12-24h
Supplement For Dialysis [Recommendation Level]: Ihd
IHD: q12-24h
Supplement For Dialysis [Recommendation Level]: Pd
PD: q12-24h
Supplement For Dialysis [Recommendation Level]: Crrt
CRRT: q8-12h, titrate to effect, after 4-5 doses spread out interval to q8-24h, [D]
References
Furlan V, Hafi A, Dessalles MC, Bouchez J, Charpentier B, Taburet AM. Methadone is poorly removed by haemodialysis [Letter]. Nephrol Dial Transplant. 1999; 14: 254-5. [PMID: 10052536]