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Published on: October 2, 2020
Effects of Hemodialysis on Methadone Pharmacokinetics and QTc
Mimi Stokke Opdal1, Margrete Arnesen2, Lill Dannevig Müller3
1Institute of Clinical Medicine, Oslo University, Oslo, Norway; Department of Pharmacology, Oslo University Hospital, Oslo, Norway.
Purpose:
Effects of hemodialysis on pharmacokinetic properties and QTc were studied in 4 patients taking daily methadone dose of 100 mg (range, 60-120 mg).
Methods:
Methadone in serum, dialysate, and urine were measured by LC-MS/MS. QTc was calculated with Bazett's formula.
Findings:
The serum Cmin methadone level was 1124 nmol/L (range, 547-1581 nmol/L). Methadone dialysate clearance was 17.1 mL/min (range, 13.7-20.6 mL/min). Total loss in dialysate was 2.30% (range, 1,25-3,70%) of daily methadone intake. QTc increased from 391 msec (range, 369-406 msec) to 445 msec (range, 407-479 msec), independently of serum methadone level, which may be explained by normalization of serum electrolytes.
Implications:
Methadone dose adjustment is not needed because of hemodialysis.
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