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Taking oxacontin from long. Will taking Methadone cause heart problems?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
I would like to know how long is it safe on your heart to take Methadone 40 mg. tablets a day. Ive been taking them for 12 years im getting concern Im 60 yr. old could you help?
i was taking oxacontin for a long while than I went to a Methadone Clinic, been their since 2001 taking about 60 mg daily. I heard that Methadone has a black box on it for the heart by a doctor I like to know more about this. It takes 2 months to start feeling just alittle better once you quit taking Methadone the last day you take it.
Posted Wed, 23 Oct 2013 in Medicines and Side Effects
Answered by Dr. Preeti Parakh 6 hours later
Brief Answer:
Risk of heart rhythm disturbance.

Detailed Answer:

Welcome to Healthcare Magic!

It is true that methadone has a black box warning for heart related problems. It states that methadone can cause the prolongation of QT interval which is a parameter measured on the electrocardiogram (ECG). This can cause an arrythmia called Torsade de pointes, which can be sometimes fatal. In less severe cases, there are usually palpitations and dizziness. Therefore, it is advisable that people on methadone be regularly screened by electrocardiogram (ECG).

I know that it is not easy to quit methadone, but maybe a reduction in dosage can be tried. Since in my knowledge, many people can manage with 40 mg/day, I feel that you can try to come down from 60 mg/day to at least 40 mg/day. The risk of arrythmia is less with lower dosages. The other thing is that with age, the metabolic system slows down and less dosages are needed for the same effects than previously. Similarly, the dose which was safe for you 10 years back may be likely to produce adverse effects now. This is another reason why you should try reducing the dose of methadone.

While the risk of arrythmia is greatest in dosages of methadone more than 100 mg/day, lower dosages may also be arrythmogenic in the presence of factors like pre-existing heart disease, drug (alcohol/ cocaine/ amphetamines etc.) dependence, or concurrent use of medicines like some antibiotics, antidepressants, antipsychotics etc. So while you are methadone, it is always safe to inform your doctor before he prescribes for any other ailments.

Hope this answers your query. Please feel free to ask if you need any clarifications.

Best wishes.

Dr Preeti Parakh
MD Psychiatry

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