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Methadone hydrochloride is a prescription opioid agonist and Schedule II controlled substance. Current oral tablet labeling includes management of severe, persistent pain inadequately controlled by other treatment options and detoxification or maintenance treatment of opioid addiction. Methadone has a long and variable elimination half-life that requires careful dose selection.
read more about methadone ...Methadone primarily activates mu-opioid receptors in the central nervous system. This changes pain signaling and reduces opioid withdrawal symptoms and cravings in physically dependent patients. Methadone can accumulate in the body with repeated doses, and its breathing-suppressing effects can last longer than its pain-relieving effects.
Methadone is used for selected patients with severe, persistent pain requiring continuous opioid treatment and for patients receiving medically supervised treatment of opioid use disorder. Its use for opioid addiction is subject to federal opioid treatment program requirements and specified exceptions. Methadone is not used as an as-needed pain medicine.
Dosing for pain is individualized by clinicians experienced with long-acting opioids, particularly when converting from another opioid. For opioid withdrawal and maintenance treatment, the initial supervised dose is commonly 20 mg to 30 mg and must not exceed 30 mg. The first day's total ordinarily does not exceed 40 mg. Maintenance dosing is adjusted gradually according to withdrawal control, tolerance, and safety. Pain and addiction treatment schedules are not interchangeable.
Methadone carries boxed warnings covering addiction, abuse, misuse, potentially fatal respiratory depression, accidental ingestion, QT prolongation and serious arrhythmias, neonatal opioid withdrawal, and dangerous medicine interactions. Benzodiazepines, alcohol, and other sedatives increase overdose risk. Drug accumulation can cause delayed respiratory depression, especially during treatment initiation or dose increases.
Methadone treats selected severe, persistent pain and is used in medically supervised opioid addiction treatment.
A supervised initial dose of 20 mg to 30 mg is common, with a maximum initial dose of 30 mg under current tablet labeling.
Methadone can accumulate over several days, and its respiratory effects can last longer than its pain-relieving effects.
Yes. The warnings include addiction, overdose, respiratory depression, serious heart rhythm changes, and potentially fatal interactions.
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Methadone. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Methadone. Date Accessed October 14, 2026.
Methadone. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK562216/. Date Accessed October 14, 2026.
Methadone. Substance Abuse and Mental Health Services Administration. https://www.samhsa.gov/substance-use/treatment/options/methadone. Date Accessed October 14, 2026.