Does Methadone Go Bad

In this brief article, we will be answering the question, “does methadone go bad?”, and will also be discussing the uses, side effects, dosage, and storage requirements of this medicine. 

Does Methadone Go Bad?

The answer to this question is not quite straightforward.

Yes, all medications including methadone have an expiry date, but this doesn’t necessarily mean that they become unsafe to use or ‘go bad’.

Medications that have passed their expiration date just begin to lose their efficacy, and may not deliver the same effects as they did before.

The pharmaceutical product shelf life, also referred to as the expiration date, is the time period during which  the product is expected to retain its identity, purity, quality, and strength when properly stored as specified in the container label. Performance of the drug product beyond the manufacturer set shelf life has been a subject of study over the past several decades. Studies have shown that many drug products retain their shelf life quality characteristics such as potency and efficacy, several years beyond the expiration date if stored properly (1).

Nevertheless, the US Food and Drug Administration (FDA) recommends disposing of medications once they expire, and to consult a doctor for a fresh new supply. 

What is Methadone Used For?

Methadone is an ‘opioid analgesic’ that functions in the brain to alter how the body experiences and reacts to pain. It is not meant for mild occasional pain, rather is prescribed to deal with chronic unbearable pain.Methadone works by changing how the brain and nervous system respond to pain (2). Methadone is also used in treating opioid addiction such as heroin addiction by preventing withdrawal symptoms brought on when opioid use is discontinued. It lessens the painful symptoms of opiate withdrawal and blocks the euphoric effects of opiate drugs such as heroin, morphine, and codeine, as well as semi-synthetic opioids like oxycodone and hydrocodone (2). It can be administered orally or intravenously in its salt form, methadone hydrochloride. The dosage is individualized according to many factors, including the severity of the pain and the patient’s tolerance of opioid analgesic (1).

How Do You Take Methadone?

Methadone tablets are taken by mouth according to a regular schedule advised by a doctor. The dosage depends on the specific medical condition and response to treatment. Methadone is offered in pill, liquid, and wafer forms and is taken once a day. Pain relief from a dose of methadone lasts about four to eight hours (2).

Methadone can be taken with or without a meal; however, if you experience nausea or gastric disturbances, take this drug with your main meal. 

For liquid methadone, carefully measure the dosage using the specific measuring spoon/device that comes with the medicine – do not use a regular household spoon since the dosage might be incorrect. 

If the medication is inside an oral dosing syringe, measure the dosage using the syringe. DO NOT inject the medication – mix the required dosage in about one ounce (30 milliliters) of water or some other liquid as directed. 

Is Methadone Addictive?

Prolonged use of methadone can result in addiction since it is an opioid drug. The risk is higher in individuals with a substance use disorder, such as the overuse of drugs/alcohol or prior problems with addiction. 

This is why it is strictly advised to use this medication as directed by the physician. Also, always let your doctor know if your condition is not improving or seems to be getting worse. 

What Happens If You Suddenly Stop Taking Methadone?

Even when the daily methadone dose appears to be adequate, many patients report withdrawal symptoms toward the end of the inter-dosing interval (i.e. the methadone dose does not ‘hold’). One possible explanation is that although patients are maintained on methadone, withdrawal symptoms may appear if there is a significant decrease in the blood levels of the drug.Methadone is well absorbed with oral bioavailability of 90% and peak concentrations are reached within 2-4 hours after oral administration. It has a relatively long mean elimination half-life of 35 hours, permitting once-daily dosing. However, inter-individual variation in the metabolism of  methadone could contribute to differences in the magnitude of opioid withdrawal symptoms over the 24-hour inter-dosing interval and those with more rapid metabolism may experience more intense withdrawal (3).

Suddenly stopping methadone results in withdrawal symptoms,  especially among individuals who have used the medicine for a long period or in high dosages. The best regime is to lower the dosage gradually. 

Withdrawal symptoms include:

  • restlessness
  • chills
  • mood or personality changes
  • anxiety
  • sleep disturbances
  • suicidal thoughts
  • flu-like symptoms (watering eyes, runny nose)
  • nausea
  • diarrhea and vomiting 
  • muscle aches

What Are The Side Effects of Methadone?

Common to all medications, methadone can cause the following side effects (2):

  • nausea and vomiting
  • Constipation
  • Lightheadedness
  • dizziness and drowsiness
  • dry mouth
  • Sweating

Some side effects eventually decrease after prolonged use of the medication; however, if any symptoms persist or worsen, immediately contact your doctor. Chronic opioid administration can compromise neuroendocrine functioning causing suppression of luteinizing hormone secretion and testosterone production. It is possible that the irritability, aggression and depression commonly reported by methadone patients may be associated with changes in hormone levels (3).

To avoid constipation, increase your intake of dietary fiber and water, and exercise. If the condition gets worse, ask your doctor to prescribe a laxative. 

To minimize the risk of lightheadedness and dizziness, lay down for some time after taking the medicine, and get up slowly after lying or sitting down.

Serious side effects of methadone include:

  • disturbed breathing while sleeping (sleep apnea)
  • mood changes (agitation, confusion)
  • hallucinations
  • abdominal pain
  • difficulty urinating
  • loss of appetite and weight loss
  • unusual tiredness

If you begin to experience any of the following very serious side effects or rare allergic reactions, immediately discontinue the medication and consult your doctor:

  • seizures
  • severe drowsiness and dizziness 
  • inability to wake up
  • rashes
  • itching and/or swelling (particularly of the face, tongue, and/or throat)
  • difficulty breathing 

How Should You Store Methadone?

Methadone should be stored in a cool, dark, and dry place below 25 degrees Celsius. Do not refrigerate the medicine. Never store medicines in a bathroom cabinet, near the sink, or on the window sill.

Also, do not leave medicines in the car, since high temperatures and humidity can cause medicines to break down.

Also, always keep medicines out of the reach of pets and children. 

Who Shouldn’t Take Methadone?

Avoid taking methadone if:

  • you are allergic to it or any other ingredients it contains
  • your breathing starts becoming shallow
  • you develop excessive lung secretions
  • you are asthmatic 
  • you are an acute alcoholic
  • you’ve had a head injury
  • you are hypertensive 
  • you are on antidepressants known as monoamine oxidase inhibitors (MAOIs)
  • you have ulcerative colitis
  • you have severe kidney or liver disease

Conclusion

In this brief article, we answered the question, “does methadone go bad?”, and also discussed the uses, side effects, dosage, and storage requirements of this medicine. 

If you have any other questions or comments please let us know.

References

  1. Khan, Saeed R., et al. United States Food and Drug Administration and Department of Defense Shelf‐Life Extension Program of Pharmaceutical Products: Progress and Promise. J Pharmac Sci, 2014, 103, 1331-1336.
  2. What Is Methadone? University of Arkansas for Medical Sciences. Center for Addiction Services and Treatment (CAST).
  3. Dyer, Kyle R., and Jason M. White. Patterns of symptom complaints in methadone maintenance patients. Addiction, 1997, 92, 1445-1455.
  4. Methadone. National Library of Medicine.