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Related Experiment Videos

Changes to methadone clearance during pregnancy.

Kim Wolff1, Annabel Boys, Amin Rostami-Hodjegan

  • 1National Addiction Centre, Division of Psychological Medicine, Institute of Psychiatry, King's College London, Addiction Sciences Building, 4, Windsor Walk, London, SE5 8AF, UK. K.wolff@iop.kcl.ac.uk

European Journal of Clinical Pharmacology
|November 2, 2005
PubMed
Summary
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Plasma methadone concentrations decrease during pregnancy, with increasing clearance rates observed in pregnant women undergoing treatment for heroin dependence. This highlights the need for careful monitoring and dose adjustments during pregnancy.

Area of Science:

  • Pharmacology
  • Obstetrics
  • Neonatology

Background:

  • Opioid dependence during pregnancy poses risks to both mother and fetus.
  • Methadone maintenance treatment is a standard care for opioid-dependent pregnant women.
  • Understanding methadone pharmacokinetics in pregnancy is crucial for optimizing treatment.

Purpose of the Study:

  • To measure plasma methadone concentrations and investigate clearance rates throughout pregnancy in women treated for heroin dependence.
  • To evaluate pregnancy outcomes in this patient population.

Main Methods:

  • A longitudinal within-subject study was conducted on nine pregnant women receiving methadone.
  • Plasma methadone concentrations were measured using high-performance liquid chromatography (HPLC) during each trimester and postpartum.

Related Experiment Videos

  • Data on pregnancy outcomes, including gestational age and neonatal birth weight, were collected.

    • Main Results:

    • Mean trough plasma methadone concentrations decreased from the first to the third trimester (0.12 mg/L to 0.07 mg/L).
    • Weight-adjusted methadone clearance rates increased during pregnancy, though individual patterns varied.
    • Pregnancies resulted in generally favorable outcomes, with most neonates having appropriate birth weights; however, some infants exhibited methadone withdrawal symptoms.

    Conclusions:

    • Prescribing methadone for heroin-dependent pregnant women offers significant benefits.
    • Clinicians should take seriously patient reports of methadone withdrawal symptoms and consider dose adjustments.
    • Further research is needed to understand factors influencing methadone metabolism during pregnancy and in neonates.