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Clin Ther. 2015 Jul 1;37(7):1594-9. doi: 10.1016/j.clinthera.2015.04.009. Epub 2015 May 8.

Effects of Hemodialysis on Methadone Pharmacokinetics and QTc.

Author information

1
Institute of Clinical Medicine, Oslo University, Oslo, Norway; Department of Pharmacology, Oslo University Hospital, Oslo, Norway. Electronic address: uxmist@ous-hf.no.
2
Department of Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway.
3
Department of Pharmacology, Oslo University Hospital, Oslo, Norway.
4
Department of Pharmacology, Oslo University Hospital, Oslo, Norway; Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway.
5
Salvation Army Hospital, Oslo, Norway.
6
Institute of Clinical Medicine, Oslo University, Oslo, Norway.
7
Department of Nephrology, Oslo University Hospital, Oslo, Norway.
8
Institute of Clinical Medicine, Oslo University, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Oslo, Norway.

Abstract

PURPOSE:

Effects of hemodialysis on pharmacokinetic properties and QTc were studied in 4 patients taking daily methadone dose of 100 mg (range, 60-120 mg).

METHODS:

Methadone in serum, dialysate, and urine were measured by LC-MS/MS. QTc was calculated with Bazett's formula.

FINDINGS:

The serum Cmin methadone level was 1124 nmol/L (range, 547-1581 nmol/L). Methadone dialysate clearance was 17.1 mL/min (range, 13.7-20.6 mL/min). Total loss in dialysate was 2.30% (range, 1,25-3,70%) of daily methadone intake. QTc increased from 391 msec (range, 369-406 msec) to 445 msec (range, 407-479 msec), independently of serum methadone level, which may be explained by normalization of serum electrolytes.

IMPLICATIONS:

Methadone dose adjustment is not needed because of hemodialysis.

KEYWORDS:

QTc; hemodialysis; methadone; methadone maintenance treatment; pharmacokinetics; renal failure

PMID:
25963997
DOI:
10.1016/j.clinthera.2015.04.009
[Indexed for MEDLINE]

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