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Updated: May 17, 2026
06:59
A Novel Approach for the Administration of Medications and Fluids in Emergency Scenarios and Settings
Published on: November 9, 2016
[Accidental levomethadone intoxication in a palliative patient]
B Michel-Lauter1, C Maier, A Schwarzer
1Abteilung für Schmerztherapie, Klinik für Anaesthesiologie, Intensiv-, Palliativ- und Schmerzmedizin, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil Bochum GmbH, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Deutschland. beate.michel-lauter@ruhr-uni-bochum.de
Schmerz (Berlin, Germany)
|October 25, 2012
Summary
Levomethadone, used for opioid replacement therapy and pain, carries risks of overdose due to its long half-life and variable absorption. Careful, individualized dosing is crucial, avoiding fixed conversion formulas from other opioids.
Area of Science:
- Pharmacology
- Clinical Pharmacy
Background:
- Levomethadone is a potent opioid utilized infrequently for specific pain conditions in Germany.
- Its primary application is in opioid replacement therapy for heroin addiction, administered as an oral fluid.
Observation:
- Levomethadone's extended plasma half-life and significant inter-individual variability pose a risk of drug accumulation and potential overdose.
- Inaccurate drug dispensing and challenges in dosage calculation are noted concerns.
Findings:
- Fixed equianalgesic dosing conversions from other opioids to levomethadone are not recommended.
- Treatment initiation requires a low starting dose followed by meticulous individual titration.
Implications:
- This case report highlights the complexities in managing levomethadone therapy, emphasizing the need for cautious dosing strategies.
- Clinical practice should prioritize individualized patient monitoring to mitigate accumulation risks and ensure therapeutic efficacy.
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