Related Experiment Video

Updated: Aug 30, 2026

Combining Laser Capture Microdissection and Microfluidic qPCR to Analyze Transcriptional Profiles of Single Cells: A Systems Biology Approach to Opioid Dependence
09:54

Combining Laser Capture Microdissection and Microfluidic qPCR to Analyze Transcriptional Profiles of Single Cells: A Systems Biology Approach to Opioid Dependence

Published on: March 8, 2020

Methadone dosage for prevention of opioid withdrawal in children

Rajashekhar Siddappa1, James E Fletcher, Andrew M B Heard

  • 1Division Pediatric Critical Care, Children's Hospital of Buffalo, Buffalo, NY Department of Anesthesiology, UNC, Chapel Hill, NC, USA.

Paediatric Anaesthesia
|November 18, 2003
PubMed

Insights

Inadequate methadone dosing increases opioid withdrawal risk in pediatric intensive care. A starting dose of 2.5 times the daily fentanyl dose effectively minimizes withdrawal symptoms in children.

Area of Science:

  • Pediatric Intensive Care
  • Pharmacology
  • Pain Management

Background:

  • Opioids are common for sedation in pediatric intensive care units (PICU), leading to tolerance and potential opioid withdrawal syndrome upon cessation.
  • Evaluating methadone dosing is crucial for managing opioid withdrawal in critically ill children.

Purpose of the Study:

  • To assess methadone dosing as a risk factor for opioid withdrawal in pediatric patients.
  • To determine the optimal methadone dose and its efficacy in preventing opioid withdrawal.

Main Methods:

  • A retrospective chart review of 30 children in a tertiary-care PICU who received opioid infusions for over 7 days and subsequently methadone for withdrawal.
  • Data collected included opioid and methadone doses, withdrawal signs documented by nurses, and patient characteristics.

Main Results:

  • Twenty out of 30 children experienced no or minimal withdrawal symptoms with methadone treatment.
  • A starting methadone dose equivalent to 80% of the predicted dose (based on fentanyl equivalents) was effective in minimizing withdrawal.
  • Inadequate methadone dosing (<80% of predicted) showed a significantly higher odds ratio (21) for withdrawal.

Conclusions:

  • Insufficient methadone dosage is a significant risk factor for developing opioid withdrawal syndrome in pediatric patients.
  • A daily starting methadone dose of 2.5 times the total daily fentanyl dose is effective in minimizing withdrawal symptoms.
Abstract

More Related Videos

Administration of &#916;9-Tetrahydrocannabinol (THC) in Adolescent and Adult Mice07:51

Administration of Δ9-Tetrahydrocannabinol (THC) in Adolescent and Adult Mice

Published on: August 1, 2025

A Procedure to Study the Effect of Prolonged Food Restriction on Heroin Seeking in Abstinent Rats10:35

A Procedure to Study the Effect of Prolonged Food Restriction on Heroin Seeking in Abstinent Rats

Published on: November 11, 2013

Related Concept Videos

Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
Opioid Analgesics: Morphine and Other Natural Cogeners01:20

Opioid Analgesics: Morphine and Other Natural Cogeners

Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents01:17

Drugs Affecting GI Tract Motility: Opioids as Antidiarrheal Agents

Diarrhea, a condition marked by frequent loose or watery bowel movements, can be triggered by multiple factors such as viral or bacterial infections, food intolerances, anxiety, medications, and digestive disorders. Symptoms may include abdominal pain, bloating, nausea, and cramping. Severe or prolonged diarrhea can lead to complications like electrolyte imbalances, malnutrition, and dehydration if left untreated.
Opioids, widely used antidiarrheal agents, mitigate diarrhea by slowing down...
Dosage Regimen: Fixed Dose01:01

Dosage Regimen: Fixed Dose

Fixed-dose regimens are a common approach to administer drugs to achieve and maintain desired levels of the drug in the body. In this dosing strategy, a specific amount of medication is given at regular intervals, often multiple times a day, to ensure a consistent drug concentration in the bloodstream.
Fixed-dose regimens can be used for various routes of administration, including intravenous (IV) injections and oral medications. For IV administration, a predetermined amount of the drug is...
Drug Dosage Regimen: Overview01:15

Drug Dosage Regimen: Overview

A drug dosage regimen describes the specific instructions and schedule for administering a drug to a patient. It considers factors such as drug dosage, frequency, route of administration, and duration of treatment. Designing an appropriate dosage regimen for a patient aims to achieve a target drug concentration at the site of action.
Typically, the starting dose and dosing interval are guided by the manufacturer's recommendations based on clinical trials conducted during and after drug...