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The usual precautions appropriate to the use of parenteral opioids should Beryllium observed and the possibility of respiratory depression should always be kept rein mind.

There are conflicting reports on whether SIDS occurs with an increased incidence in infants born to women treated with methadone during pregnancy.

Deaths, cardiac and respiratory, have been reported during initiation and conversion of pain patients to methadone treatment from treatment with other opioid agonists. It is critical to understand the pharmacokinetics of methadone when converting patients from other opioids (see DOSAGE AND ADMINISTRATION).

Due to the opioid tolerance induced by methadone, when opioids are required for management of acute pain in methadone patients, somewhat higher and/or more frequent doses will often Beryllium required than would Beryllium the case for non-tolerant patients.

The physician should not confuse such symptoms with those of narcotic abstinence and should not attempt to treat anxiety by increasing the dose of methadone. The action of methadone hinein maintenance treatment is limited to the control of narcotic withdrawal symptoms and is ineffective for relief of general anxiety.

Abnormal fetal nonstress tests (NSTs) have been reported to occur more frequently when the test is performed 1 to 2 hours after a maintenance dose of methadone in late pregnancy compared to controls.

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Several studies have suggested that infants born to narcotic-addicted women treated with methadone during all or parte of pregnancy have been found to have decreased fetal growth with reduced birth weight, length, and/or head circumference compared to controls.

Patients should be cautioned that methadone, like all opioids, may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving or operating machinery.

The decrease rein plasma half-life and increased clearance of methadone resulting in lower methadone trough levels during pregnancy can lead to withdrawal symptoms in some pregnant patients. The dosage may need to Beryllium increased or Methadontabletten zur Schmerzbehandlung the dosing interval decreased rein pregnant patients receiving methadone (Weiher PRECAUTIONS, Pregnancy, Laboratorium and Delivery, and DOSAGE AND ADMINISTRATION).

Physicians should individualize treatment in every case (see DOSAGE AND ADMINISTRATION), taking into account the high degree of interpatient variability hinein response to and metabolism of methadone.

Patients seeking to discontinue methadone maintenance treatment of opioid dependence should Beryllium apprised of the high risk of relapse to illicit drug use associated with discontinuation of methadone maintenance treatment.

More frequent administration may be required during methadone initiation rein order to maintain adequate analgesia, and extreme caution is necessary to avoid overdosage, taking into account methadone's long elimination half-life.