Medications not yet evaluated by P&T are considered NON-FORMULARY . . . . . Always check 2 unique patient identifiers - NAME and DATE OF BIRTH - at every step! . . . . . Please be sure to document all clinical activities daily.
Search results for:

methadone

methadone
Drug Name Form Strength Formulary Unrestricted Formulary Restricted Non-Formulary Interchange
Methadone SOLUTION, INJECTABLE 10 mg/mL      
Methadone SOLUTION, ORAL 10 mg/5 mL      
Methadose, Dolophine TABLET, ORAL 5 mg, 10 mg      
VIEW MORE Opioid Agonists
CLASS
280808
Comments:
  • Criteria for use of injectable methadone by palliative care/hospice
    • Intravenous methadone can be considered in patients who meet all of the following criteria:
      • Are unable to tolerate oral opioids or archieve adequate pain relief on oral opioids
      • Meet one of the following:
        • Have uncontrolled pain despite maximum tolerated parenteral opioids
        • Have adequate pain control and are experiencing unwanted dose-related side effect with parenteral opioids
    • Subcutaneous/intramuscular methadone can be considered in patients who meet all the following criteria:
      • Meet the criteria for intravenous methadone, as defined above
      • Lack ability to maintain or gain access to intravenous administration

Dolophine medication guide

Methadone Reference Sheet

Methadone Clinic Request for Information Form

REMS (Dolophine, Methadose, methadone): View FDA REMS Info

Reviewed February 25, 2020

Updated: November 2020

 

Last updated: Mar. 29, 2023






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