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06:27
Transcutaneous Microcirculatory Imaging in Preterm Neonates
Published on: December 31, 2015
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Methadone dosing strategies in preterm neonates can be simplified
Tamara van Donge1, Samira Samiee-Zafarghandy2, Marc Pfister1,3
1Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel, University of Basel, Basel, Switzerland.
British Journal of Clinical Pharmacology
|February 27, 2019
Summary
Neonatal Abstinence Syndrome (NAS) treatment with methadone in preterm infants shows clearance increases with gestational age. A simplified, shorter dosing strategy can effectively manage withdrawal symptoms.
Area of Science:
- Pharmacology
- Neonatal Medicine
- Drug Development
Background:
- Neonatal Abstinence Syndrome (NAS) is increasing, often treated with complex methadone regimens.
- Limited pharmacokinetic (PK) data exists for methadone in preterm neonates.
Purpose of the Study:
- Investigate the developmental PK of methadone in preterm infants.
- Evaluate current methadone dosing strategies and explore simplification.
Main Methods:
- A single-centre, open-label prospective study collected PK data after oral methadone doses.
- A population PK model characterized (R)- and (S)-methadone developmental PK.
- Model-based simulations identified simplified dosing strategies.
Main Results:
- 121 methadone concentrations from 31 preterm neonates were analyzed.
- Clearance increased with gestational age and differed between R- and S-methadone enantiomers.
- Current dosing achieved target exposure within 48 hours; simulations showed a simplified 4-day strategy is effective.
Conclusions:
- Methadone clearance in preterm neonates is influenced by gestational age and chirality.
- A shorter, simplified methadone dosing strategy can maintain target exposure for NAS symptom control.
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