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Details

Stereochemistry RACEMIC
Molecular Formula C21H27NO.HI
Molecular Weight 437.3576
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of METHADONE HYDRIODIDE

SMILES

I.CCC(=O)C(CC(C)N(C)C)(C1=CC=CC=C1)C2=CC=CC=C2

InChI

InChIKey=BUQLQYUUFYFANQ-UHFFFAOYSA-N
InChI=1S/C21H27NO.HI/c1-5-20(23)21(16-17(2)22(3)4,18-12-8-6-9-13-18)19-14-10-7-11-15-19;/h6-15,17H,5,16H2,1-4H3;1H

HIDE SMILES / InChI

Molecular Formula HI
Molecular Weight 127.91241
Charge 0
Count
Stereochemistry ACHIRAL
Additional Stereochemistry No
Defined Stereocenters 0 / 0
E/Z Centers 0
Optical Activity NONE

Molecular Formula C21H27NO
Molecular Weight 309.4452
Charge 0
Count
Stereochemistry RACEMIC
Additional Stereochemistry No
Defined Stereocenters 0 / 1
E/Z Centers 0
Optical Activity ( + / - )

Description
Curator's Comment: description was created based on several sources, including: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/006134s040s041lbl.pdf | https://www.drugs.com/pro/diskets.html

Methadone, sold under the brand names Dolophine among others, is an synthetic opioid that is used as the hydrochloride to treat pain and as maintenance therapy or to help with detoxification in people with opioid dependence. Methadone hydrochloride is a mu-agonist; a synthetic opioid analgesic with multiple actions qualitatively similar to those of morphine. Some data also indicate that methadone acts as an antagonist at the NMDA-receptor. The contribution of NMDA receptor antagonism to methadone’s efficacy is unknown. Most common adverse reactions are: lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. Avoid use mixed agonist/antagonist and partial agonist opioid analgesics with DOLOPHINE because they may reduce analgesic effect of DOLOPHINE or precipitate withdrawal symptoms.

CNS Activity

Curator's Comment: https://www.ncbi.nlm.nih.gov/pubmed/5084666

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
3.51 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
DOLOPHINE HYDROCHLORIDE

Approved Use

For the treatment of moderate to severe pain not responsive to non-narcotic analgesics. For detoxification treatment of opioid addiction (heroin or other morphine-like drugs). For maintenance treatment of opioid addiction (heroin or other morphine-like drugs), in conjunction with appropriate social and medical services. Note – Outpatient maintenance and outpatient detoxification treatment may be provided only by Opioid Treatment Programs (OTPs) certified by the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) and registered by the Drug Enforcement Administration (DEA). This does not preclude the maintenance treatment of a patient with concurrent opioid addiction who is hospitalized for conditions other than opioid addiction and who requires temporary maintenance during the critical period of his/her stay, or of a patient whose enrollment has been verified in a program which has been certified for maintenance treatment with methadone.

Launch Date

1947
Palliative
DOLOPHINE HYDROCHLORIDE

Approved Use

For the treatment of moderate to severe pain not responsive to non-narcotic analgesics. For detoxification treatment of opioid addiction (heroin or other morphine-like drugs). For maintenance treatment of opioid addiction (heroin or other morphine-like drugs), in conjunction with appropriate social and medical services. Note – Outpatient maintenance and outpatient detoxification treatment may be provided only by Opioid Treatment Programs (OTPs) certified by the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) and registered by the Drug Enforcement Administration (DEA). This does not preclude the maintenance treatment of a patient with concurrent opioid addiction who is hospitalized for conditions other than opioid addiction and who requires temporary maintenance during the critical period of his/her stay, or of a patient whose enrollment has been verified in a program which has been certified for maintenance treatment with methadone.

Launch Date

1947
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
494 ng/mL
76 mg 1 times / day steady-state, oral
dose: 76 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
40.2 ng/mL
10 mg single, oral
dose: 10 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHADONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
548 ng/mL
0.89 mg/kg 1 times / day steady-state, oral
dose: 0.89 mg/kg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
54 ng/mL
0.89 mg/kg 1 times / day steady-state, oral
dose: 0.89 mg/kg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
8.27 μg × h/mL
76 mg 1 times / day steady-state, oral
dose: 76 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
1073 ng × h/mL
10 mg single, oral
dose: 10 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHADONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
8.54 mg × h/L
0.89 mg/kg 1 times / day steady-state, oral
dose: 0.89 mg/kg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
0.61 mg × h/L
0.89 mg/kg 1 times / day steady-state, oral
dose: 0.89 mg/kg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
39 h
76 mg 1 times / day steady-state, oral
dose: 76 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
39.3 h
10 mg single, oral
dose: 10 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHADONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
31.2 h
0.89 mg/kg 1 times / day steady-state, oral
dose: 0.89 mg/kg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
Doses

Doses

DosePopulationAdverse events​
10 mg 3 times / day multiple, intravenous
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
pregnant, adult
Health Status: pregnant
Age Group: adult
Sex: F
Sources:
Other AEs: Withdrawal syndrome neonatal...
10 mg 3 times / day multiple, intravenous
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
Other AEs: Respiratory depression, Addiction...
Other AEs:
Respiratory depression (grade 5)
Addiction
QT interval prolonged (grade 5)
Sources:
20 mg single, oral
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
Other AEs: Respiratory depression, QT interval prolonged...
Other AEs:
Respiratory depression (grade 5)
QT interval prolonged
Arrhythmia (serious)
Sources:
AEs

AEs

AESignificanceDosePopulation
Withdrawal syndrome neonatal
10 mg 3 times / day multiple, intravenous
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
pregnant, adult
Health Status: pregnant
Age Group: adult
Sex: F
Sources:
Addiction
10 mg 3 times / day multiple, intravenous
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
QT interval prolonged grade 5
10 mg 3 times / day multiple, intravenous
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
Respiratory depression grade 5
10 mg 3 times / day multiple, intravenous
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
QT interval prolonged
20 mg single, oral
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
Respiratory depression grade 5
20 mg single, oral
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
Arrhythmia serious
20 mg single, oral
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
OverviewDrug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
yes
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Frequency of high-risk use of QT-prolonging medications.
2006-06
Changes in HIV risk behaviors among patients receiving combined pharmacological and behavioral interventions for heroin and cocaine dependence.
2006-05
Variables associated with perceived sleep disorders in methadone maintenance treatment (MMT) patients.
2006-04-28
Methadone treatment of chronic non-malignant pain and opioid dependence--a long-term follow-up.
2006-04
Does naltrexone treatment lead to depression? Findings from a randomized controlled trial in subjects with opioid dependence.
2006-01
Bradycardia during methadone therapy in an infant.
2006-01
A randomized controlled trial of interim methadone maintenance.
2006-01
Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver.
2005-12-12
QT prolongation and torsades de pointes among methadone users: reports to the FDA spontaneous reporting system.
2005-11
[Torsades de pointes during methadone treatment].
2005-10
Methadone doses of 100 mg or greater are more effective than lower doses at suppressing heroin self-administration in opioid-dependent volunteers.
2005-10
QT prolongation and syncope with methadone, doxepin, and a beta-blocker.
2005-10
Central sleep apnea in stable methadone maintenance treatment patients.
2005-09
[Methadone-induced heart arrhythmia].
2005-08-11
Methadone-induced bradycardia.
2005-07
Neuropsychological functioning in methadone maintenance patients versus abstinent heroin abusers.
2005-06-01
Methadone-induced Torsade de pointes tachycardias.
2005-05-14
Effects of buprenorphine on cardiac repolarization in a patient with methadone-related torsade de pointes.
2005-04
Torsades de pointes with methadone.
2005-04
Measurement of QTc in patients receiving chronic methadone therapy.
2005-04
Methadone-related Torsades de Pointes in a sickle cell patient treated for chronic pain.
2005-04
Dextromethorphan-induced delirium and possible methadone interaction.
2005-03
[Methadone and sleep apnea syndrome].
2005-03
Caution with nalbuphine in patients on long-term opioids.
2005-03
Methadone versus buprenorphine with contingency management or performance feedback for cocaine and opioid dependence.
2005-02
Methadone maintenance and male sexual dysfunction.
2005
Cocaine-related torsade de pointes in a methadone maintenance patient.
2005
Adipocyte-derived hormones in heroin addicts: the influence of methadone maintenance treatment.
2005
QTc interval prolongation in patients on long-term methadone maintenance therapy.
2005
Obsessive-compulsive symptoms precipitated by methadone tapering.
2004-12
[Routine ECG in methadone-assisted rehabilitation is wrong prioritization].
2004-11-18
Methadone-induced torsade de pointes in a patient with normal baseline QT interval.
2004-10-09
Oral methadone for cancer pain: no indication of Q-T interval prolongation or torsades de pointes.
2004-10
Intravenous ketamine infusion as an adjuvant to morphine in a 2-year-old with severe cancer pain from metastatic neuroblastoma.
2004-10
[Preclinical management of accidental methadone intoxication of a 4-year-old girl. Antagonist or intubation?].
2004-10
[Long QT and torsade de pointes in a patient with acquired human immunodeficiency virus infection in multitherapy with drugs affecting cytochrome P450].
2004-09
Epidural clonidine, bupivacaine and methadone as the sole analgesic agent after thoracotomy for lung resection.
2004-09
[Life-threatening, recurrent arrhythmia in patients on high-dose methadone treatment: torsade de pointes].
2004-08-30
Methadone metabolism by human placenta.
2004-08-01
QT interval prolongation in patients on methadone with concomitant drugs.
2004-08
Directly observed therapy for the management of HIV-infected patients in a methadone program.
2004-06-01
The effect of quinidine, used as a probe for the involvement of P-glycoprotein, on the intestinal absorption and pharmacodynamics of methadone.
2004-05
Agonist-like or antagonist-like treatment for cocaine dependence with methadone for heroin dependence: two double-blind randomized clinical trials.
2004-05
Cost effectiveness of disulfiram: treating cocaine use in methadone-maintained patients.
2004-04
[Development of transmural myocardial infarction in young persons with intact coronary arteries during methadone use for the treatment of heroine addiction].
2004
Relationship between prescribing and risk of opiate overdose among drug users in and out of maintenance treatment.
2004
Tiagabine increases cocaine-free urines in cocaine-dependent methadone-treated patients: results of a randomized pilot study.
2003-11
QT prolongation and Torsades de Pointes in patients infected with human immunodeficiency virus and treated with methadone.
2003-10-15
[Torsade de pointes: a severe and unknown adverse effect in a patient taking methadone].
2003-10-08
Reversible spastic paraparesis induced by high-dose intravenous methadone.
2001-02
Patents

Sample Use Guides

Chronic pain: oral initial dose - 2.5 mg every 8 to 12 hours; Intravenous initial dose: 2.5 mg to 10 mg every 8 to 12 hours Opiate withdrawal: Initial dose - 20 to 30 mg orally; an additional 5 to 10 mg may be given orally after 2 to 4 hours if withdrawal symptoms have not been suppressed or if symptoms reappear. -Maximum initial dose: 30 mg -Maximum day 1 dose: 40 mg
Route of Administration: Other
In the presence of 1 uM methadone, the maximum 86Rb+ efflux stimulated by nicotine (Emax) was markedly reduced, but the EC50 for nicotine was altered only slightly, if at all.
Substance Class Chemical
Created
by admin
on Mon Mar 31 20:55:55 GMT 2025
Edited
by admin
on Mon Mar 31 20:55:55 GMT 2025
Record UNII
MS4P249SDR
Record Status Validated (UNII)
Record Version
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Name Type Language
3-HEPTANONE, 6-(DIMETHYLAMINO)-4,4-DIPHENYL-, HYDRIODIDE
Preferred Name English
METHADONE HYDRIODIDE
Common Name English
Code System Code Type Description
FDA UNII
MS4P249SDR
Created by admin on Mon Mar 31 20:55:55 GMT 2025 , Edited by admin on Mon Mar 31 20:55:55 GMT 2025
PRIMARY
PUBCHEM
171389978
Created by admin on Mon Mar 31 20:55:55 GMT 2025 , Edited by admin on Mon Mar 31 20:55:55 GMT 2025
PRIMARY
CAS
16896-75-6
Created by admin on Mon Mar 31 20:55:55 GMT 2025 , Edited by admin on Mon Mar 31 20:55:55 GMT 2025
PRIMARY
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