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. 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

Mimi Stokke Opdal  1 , Margrete Arnesen  2 , Lill Dannevig Müller  3 , Ingunn Hullstein  4 , Karim Sayed  5 , Odd Brørs  6 , Marianne Kringen  3 , Solbjørg Sagedal  7 , Knut Gjesdal  8 , Peter Krajci  2
Affiliations

Effects of Hemodialysis on Methadone Pharmacokinetics and QTc

Mimi Stokke Opdal et al. Clin Ther. .

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.

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