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Whats The Difference Between Liquid And Pill Form Of Methadone?

Updated     17



Heather Says:
 
I think i have a drug test coming up at the clinic and i have methadone pills instead of the liquid that i usually take. Will taking the pill form give me a dirty urine at the clinic?

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David Says:
 
Hi Heather,

From what I was able to gather, the active ingredient is still the same in the pill vs liquid form. The main difference being that the different binders in the pill will make it work through your system slower than the liquid form. It also shouldn't show up as anything different in a urinary analysis, being that it is still methadone.

If you were prescribed methadone, then you shouldn't have anything to worry about. Just present the lab with a proof of your prescription prior to the screening, so that you won't be held accountable for a dirty urine sample.

I know your post is from the end of November, so I take it you may have already had your test at the clinic? If you did, what were your results?

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2
kATHY Says:
 
I have been on 40 mgs of methadone for 7 years and tried to switch to pill form....I got an overWELMING
feeling ,very nervous and wandered what could be different as far as ingredients,also Im on Benicar and a water pill for bloodpressure.It was awefulKathyKl.

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3
Kathy Says:
 
I have been on 40 mgs of methadone for seven years,due to financial burdens I opted to seek a specialist who changed my dose to a liquid form.I had a horrible reactionfeeling an overwhelming rush,ending in hours of anxiety, nausia,it was aweful.I also take BENICAR and Diazide for blood pressure.Is there anything different in the pill?

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4
mike Says:
 
I take 40mg of Methadone every 8 hours for chronic pain due to severe migraine headaches. I was taking it in liquid form, but due to cost and the pharmacy not always having the liquid in stock my doctor had me switch to tablets(4x10mg tablets every 8 hours) the problem I have encountered is after 7 hours I start sweating profusely and feel anxious until I take my next dose and it absorbs, which usually takes aproximately 1hour15 minutes after ingestion. Is this normal and would switching to 3X10mg tablets every 6 hours make a difference? would like to stick with 120mg/day.

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5
Jace Mathews Says:
 
I dose 72 mg of liquid methadose and sometimes i have access to the pill form of methadone that i get from an old frien who takes it. Sense i dose in the morning the effects where off at night because i havent stabilized yet. If ive taken the pill form and dosed on the liquid form and then got a drug screen would it just show up as methadone or would their be any indication that i had also ingested the pills?

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6
Zaniyah Says:
 
im interested to know if there is some type of different ingredients in the liquid vs. pill form of methadone..i was prescribed the pill form of methadone..70 mgs per day...twice per day...which worked out well...however, i was switched over to the liquid form and a higher dose of 190 per day...as a result thereof, i retained extreme water retention..edema...my feet swelled up very bad...my legs..my weight went from 160 lbs...to 210 lbs..my legs were in extreme pain everyday. Other than the fact of this extreme reaction...i like methadone for management of pain. Trying to make a long story short, I stopped using methadone for one year. I am now considering using this drug again, but cannot get the pill form. I am terrified that the edema will happen again, but am going to try to keep my dose under 70 mgs. Question..is there any information regarding liquid vs. pill form of methadone


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7
DrDave Says:
 
ALSO, There are more than two Methadone Patents. I've listed the links below. DIFFERENT forms of Methadone are made for/from DIFFERENT ingredients. When you go to the links below, look at the upper left side of the pages, there you will find other links on the patent in question, detailing MUCH MORE INFO!

Some Methadone contains an opiate antagonist, which will counteract the euphoric effects, ALL MMT Methadone (Liquid Racemic Mix) has this, Methadone for Pain Management DOES NOT. So PLEASE read ALL the info on the patent pages, including the links in the upper left for; Overview / abstract / Drawings / Description Claims.

Here are the CURRENT Various USA Patents for making "Methadone".... Same 'Name', yet completely DIFFERENT EFFECTS. WHY they are all called "Methadone" is really a puzzle to much of the medical community, as well as MMT clinics. Links below:

http:/­/­www.google.com/­patents/­US6897242

http:/­/­www.google.com/­patents/­US6008258

http:/­/­www.google.com/­patents/­US20100010096

http:/­/­www.google.com/­patents/­US3843696

http:/­/­www.google.im/­patents/­US5587381

"Methadone", as you will find IS NOT THE SAME.... Not even made the same! I hope this helps those of you who have found different effects from various 'forms' of what you think is the 'same thing'.... THEY ARE NOT !!!

DrDave, PhD in Pharmacology
--------------------------------------------------------------
There IS A Difference, READ BELOW:
FROM: THE MOUNT SINAI JOURNAL OF MEDICINE Vol. 67 Nos. 5 & 6 October/November 2000 LINK: http:/­/­www.drugpolicy.org/­docUploads/­meth412.pdf

Basic Pharmacology:
Methadone is a synthetic opioid with a long and variable half-life (between 12 and 100 hours (4). Although it can be administered intravenously or intramuscularly to treat pain, its utility as a maintenance medication in the treatment of opioid addiction is based on its long half-life and ready, reliable absorption when used as an oral medication. The slow onset of methadone taken orally does not produce a sudden “rush,†and produces no euphoric effects in most patients (5). As a treatment for opioid addiction, it is effective in blocking craving and withdrawal for 24 - 36 hours. For decades, methadone has also been used as an analgesic, and interest in the drug for pain treatment for has been increasing because of recent evidence that the commercially available racemic mixture includes an isomer that does not bind to opioid receptors, but is an antagonist at the n-methyl-D-aspartate (NMDA) receptor. By blocking this receptor, this d-isomer could potentially yield analgesia by a mechanism that potentiates that produced by binding of the l-isomer to the opioid receptor. Moreover, NMDA-receptor antagonism reverses opioid tolerance, and this effect may explain the unexpectedly high anal- gesic potency of methadone when it is administered to patients who are receiving another mu agonist drug.
The analgesic effects of methadone typically last 4-8 hours after a dose. Although some patients are able to achieve stable analgesia with dosing every 12 hours, most patients require analgesic doses every 6-8 hours, and some can avoid end-of-dose failure only by dosing every 4 hours.
Single-dose, controlled analgesic studies indicate that methadone is slightly more potent, on a milligram per milligram basis, than morphine sulfate (6). These studies have limited relevance to chronic administration, during which the combination of kinetic factors (a slow and gradual increase of plasma concentration because of the long half-life) and dynamic factors (increased potency presumably because of the NMDA - receptor antagonism of the d-isomer) produce an unexpectedly high potency, gradual accrual of effects over days to a week or more, and variabil- ity in response based on the existing therapy. As a result of these factors, current guidelines indicate that the use of methadone for pain should be initiated at a dose that is 75 - 90% lower than the calculated equianalgesic dose. This initial dose is usually co-administered with a short-acting opioid “rescue†medication. Close monitoring during dose titration is needed until sufficient time has passed at a stable dosing level to ensure that the plasma concentration has reached a plateau. This steady state plateau, which requires 4 - 5 half-lives to achieve, can in the case of methadone require days to weeks.

There IS More... YES THE PILLS ARE DIFFERENT!!!!!
Again, The liquid or 'racemic mixture' includes an isomer that does not bind to opioid receptors, but is an antagonist at the n-methyl-D-aspartate (NMDA) receptor. By blocking this receptor, this d-isomer could potentially yield analgesia by a mechanism that potentiates that produced by binding of the l-isomer to the opioid receptor.

SOURCE: THE MOUNT SINAI JOURNAL OF MEDICINE Vol. 67 Nos. 5 & 6 October/November 2000

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8
Jaiyden Says:
 
I also had this reaction to methadone when I started it. (100mg/day) However, I found the side affects were a lot better than the pain I have when not taking it, so I stuck it out. After three months the side affects started to greatly recede and by 6 months I had no side affects at all. If you can handle a few months of the swelling, it should get better. Hope this helps.

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9
Texan Says:
 
Dr Dave in the United states racemic methadone is the only form of methadone available. It is cheaper to produce than the pure formulation. Liquid is not the only methadone offered at clinics. A lot of clinics offer the 40 mg wafer. The 40 mg wafer is only available in hospitals and clinics. It was outlawed for pain in a non hospital setting to keep people from overdosing. One 40 mg wafer can kill a non opioid tolerant person. I do not know where you came up with liquid being racemic and pills not.
You can read about this at Wiley online library :
(R)-methadone versus racemic methadone: what is best for patient care?NXDKD


A proposed solution is the use of a form of methadone that contains only the (R)-enantiomer. This methadone formulation is available in the European Union and is in widespread use in Germany. The use of a pure (R)-formulation of methadone results in lower effective doses, but its cost is up to 20% higher than the racemic formulation (S. Walcher MD, personal communication).

Some in the United States have suggested that racemic methadone be replaced by (R)-methadone. However, this formulation of methadone is not US Food and Drug Administration (FDA)-approved and, therefore, cannot be prescribed in the United States. As a new drug, it is likely that the FDA will require safety testing and clinical trials to show its equivalence to the currently available racemic mixture. Even if the FDA were to expedite the approval process, substantial costs would be incurred by a pharmaceutical manufacturer undertaking this drug development. It is likely that this methadone formulation would be significantly more expensive than currently available methadone in the United States. Further, the use of (R)-methadone would probably increase the cost of methadone treatment in developing nations, for whom this intervention is critically important and for whom higher costs may result in either a reluctance to provide the treatment or to expand the capacity of existing treatment facilities.

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10
eric Says:
 
hello I have been on 35 mg of methadone for a little over a year now, i have tried to detox twice due to finances but was unable to. I am currently thinking of switching to suboxone or subutex for the simple fact that some dr have told me its easier to detox from is that really true? I also am writing a book right now about addiction and methadone subutex and suboxone and the role they play in my rehab so any info would be greatly appreciated.

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11
tessos Says:
via mobile
 
Hey the reason you are sweating is becauseyour are withdrawing..your body is use to ythat dose and now you prob feel like you want to go up another 5-10mls.DONT just have it ealier than you usally do. Just my opinion one person.everyones different iv been on methadone its a killer to get off and iv been on suboxone. So I know how you feel.

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12
Lisa Says:
 
O M G Than basically u r writing a book on addictions and you are on 35 mgs of methadone? Than I feel like I am basically Effed! I am on 160 mgs per day and have been on (this doseage for 31é2 years and prior to that 120 for 4 years! Had lower back issues...surgery; yes I know, boo hoo. but NOW after 8 years, getting my life back, in university, trying to get a sense of "NORMALCY" in my life, as all the specialists said I would....well LO and Behold-NADA! Try to plan a vacation to the Caribbean? Try to book a weekend with your new husband (of 3 years) to a spa? The answer is NO! You cannot without getting in touch with the Embassy's and/or having a doctors (prescribing doctor's letter etc -hopefully the doc. is in the Country!- no "surprises here! let alone feeling like an addict yourself while it IS the doc's opinion that this IS the route you should take!) REALLY!?! AND HOW is THIS "freeing" me? Really?) ANYWAY, PLEASE, I WANT OUT! HOW and WHAT can I DO? FEELING TRAPPED EVEN WORSE NOW THAN EVER....as I have had a feel of the freedom-yet still "attached"...WHAT AM I "supposed" to do? how do I REALLY get off this Sh@%! ?
Desperately seeking....HELP, In Canada!


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13
Michelle Says:
via mobile
 
you're on 160mg of mmt? so am I if you want to email me we can talk about options and what not as I have been looking to come down and off of it as well My email is: {edited for privacy}

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14
Bryan Says:
 
I would say that is very untrue unless you want an extra full month of withdrawls. Subutex and Suboxone have the longest half lives by far and stay in the system a really long time. It is not uncommon to have withdrawl symptoms for up to two months. Doctors have absolutely no clue.

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15
Kristi Ford Says:
via mobile
 
Does it make your hands and feet swell and cause all your joints to hurt when you first wake up in the morning?

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16
STEFANIE Says:
via mobile
 
SUBUTEX! I get 90 of the 8mg pills, a month. I was doing 50+ bags of heroin a day, shooting & insufflating. I dexoted in 8 days with my Subutex. 9th day I woke up fine & never went thru withdrawls again. Of course u still get cravings and I have f***ed up and had to retake the Subutex to detox again. ITS VERY FAST AND QUICK, EVEN SUBOXONE CAN BE. Once you wake up and FEEL NORMAL AGAIN, and go A WHOLE DAY, go to BED WAKE UP AND FEEL NORMAL AGAIN THE NEXT DAY U NO LONGER NEED TO TAKE THE SUBUTEX OR SUBOXONE ANYMORE, YOUR DETOXED & DONE THATS WHY PPL GET HOOKED ON SUBOXONE N SUBUTEX I KNOW SOMEONE BEEN HOOKED ON SUBS FOR 4YRS TO GET OFF BLUES (oxycodone 30s) and he's stil taking them til this day cuz if not HES WITHDRAWLING. CUZ WHEN HE FELT OKAY AFTER HOWEEVER AMOUNT OF DAYS HE CONTINUED TAKING THEM. U STOP!!!

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17
carrie14 Says:
 
I'm new to the Methadone clinic. I was kicked off my pain contract for using pot, & found myself in the Methadone clinic. I've noticed a huge difference between my pills and the liquid I get at the clinic. Though my dose has doubled since starting the clinic 2&1/2 months ago, I've noticed I do not have any feelings of contentment. It feels like I'm at the very beginning stages of withdrawl. I've even used my Sunday dose before to see if an increase is necessary, but still, I feel the same. Does anyone know what is going on with me. My pain is out of control and there's not 1damn thing I can do about it.

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