PMID- 22429858
OWN - NLM
STAT- MEDLINE
DCOM- 20121009
LR  - 20211021
IS  - 1747-597X (Electronic)
IS  - 1747-597X (Linking)
VI  - 7
DP  - 2012 Mar 20
TI  - Survey of methadone-drug interactions among patients of methadone maintenance 
      treatment program in Taiwan.
PG  - 11
LID - 10.1186/1747-597X-7-11 [doi]
AB  - BACKGROUND: Although methadone has been used for the maintenance treatment of 
      opioid dependence for decades, it was not introduced in China or Taiwan until 
      2000s. Methadone-drug interactions (MDIs) have been shown to cause many adverse 
      effects. However, such effects have not been scrutinized in the ethnic Chinese 
      community. METHODS: The study was performed in two major hospitals in southern 
      Taiwan. A total of 178 non-HIV patients aged >/= 20 years who had participated in 
      the Methadone Maintenance Treatment Program (MMTP) >/= 1 month were recruited. An 
      MDI is defined as concurrent use of drug(s) with methadone that may result in an 
      increase or decrease of effectiveness and/or adverse effect of methadone. To 
      determine the prevalence and clinical characteristics of MDIs, credible data 
      sources, including the National Health Insurance (NHI) database, face-to-face 
      interviews, medical records, and methadone computer databases, were linked for 
      analysis. Socio-demographic and clinical factors associated with MDIs and 
      co-medications were also examined. RESULTS: 128 (72%) MMTP patients took at least 
      one medication. Clinically significant MDIs included withdrawal symptoms, which 
      were found among MMTP patients co-administered with buprenorphine or tramadol; 
      severe QTc prolongation effect, which might be associated with use of haloperidol 
      or droperidol; and additive CNS and respiratory depression, which could result 
      from use of methadone in combination with chlorpromazine or thioridazine. Past 
      amphetamine use, co-infection with hepatitis C, and a longer retention in the 
      MMTP were associated with increased odds of co-medication. Among patients with 
      co-medication use, significant correlates of MDIs included the male gender and 
      length of co-medication in the MMTP. CONCLUSIONS: The results demonstrate 
      clinical evidence of significant MDIs among MMTP patients. Clinicians should 
      check the past medical history of MMTP clients carefully before prescribing 
      medicines. Because combinations of methadone with other psychotropic or opioid 
      medications can affect treatment outcomes or precipitate withdrawal symptoms, 
      clinicians should be cautious when prescribing these medications to MMTP patients 
      and monitor the therapeutic effects and adverse drug reactions. Although it is 
      difficult to interconnect medical data from different sources for the sake of 
      privacy protection, the incumbent agency should develop pharmacovigilant measures 
      to prevent the MDIs from occurring. Physicians are also advised to check more 
      carefully on the medication history of their MMTP patients.
FAU - Lee, Hsin-Ya
AU  - Lee HY
AD  - School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, No,100 
      Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
FAU - Li, Jih-Heng
AU  - Li JH
FAU - Wu, Li-Tzy
AU  - Wu LT
FAU - Wu, Jin-Song
AU  - Wu JS
FAU - Yen, Cheng-Fang
AU  - Yen CF
FAU - Tang, Hsin-Pei
AU  - Tang HP
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20120320
PL  - England
TA  - Subst Abuse Treat Prev Policy
JT  - Substance abuse treatment, prevention, and policy
JID - 101258060
RN  - 0 (Antidepressive Agents)
RN  - 0 (Antipsychotic Agents)
RN  - 0 (Hypnotics and Sedatives)
RN  - 0 (Narcotics)
RN  - UC6VBE7V1Z (Methadone)
SB  - IM
MH  - Adult
MH  - Antidepressive Agents/adverse effects/*therapeutic use
MH  - Antipsychotic Agents/adverse effects/*therapeutic use
MH  - Arrhythmias, Cardiac/etiology
MH  - Drug Interactions
MH  - Female
MH  - Hepatitis B/complications
MH  - Hepatitis C/complications
MH  - Humans
MH  - Hypnotics and Sedatives/adverse effects/*therapeutic use
MH  - Male
MH  - Methadone/*therapeutic use
MH  - Middle Aged
MH  - Narcotics/adverse effects/*therapeutic use
MH  - *Opiate Substitution Treatment
MH  - Opioid-Related Disorders/complications/*drug therapy
MH  - Prospective Studies
MH  - Respiratory Insufficiency/etiology
MH  - Risk Factors
MH  - Substance Withdrawal Syndrome/etiology
MH  - Taiwan
PMC - PMC3373376
EDAT- 2012/03/21 06:00
MHDA- 2012/10/10 06:00
PMCR- 2012/03/20
CRDT- 2012/03/21 06:00
PHST- 2011/11/08 00:00 [received]
PHST- 2012/03/20 00:00 [accepted]
PHST- 2012/03/21 06:00 [entrez]
PHST- 2012/03/21 06:00 [pubmed]
PHST- 2012/10/10 06:00 [medline]
PHST- 2012/03/20 00:00 [pmc-release]
AID - 1747-597X-7-11 [pii]
AID - 10.1186/1747-597X-7-11 [doi]
PST - epublish
SO  - Subst Abuse Treat Prev Policy. 2012 Mar 20;7:11. doi: 10.1186/1747-597X-7-11.