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Tracy Hampton, PhD

JAMA. 2007;297:354.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The US Food and Drug Administration (FDA) has issued an alert about reports of death and respiratory depression, cardiac arrhythmias, and other life-threatening adverse events in patients receiving methadone for chronic pain (http://www.fda.gov/cder/drug/infopage/methadone/default.htm).

Fatalities have been reported in patients who were switched from chronic, high-dose treatment with other opioids to methadone and in patients initiating treatment with methadone. The reported deaths and adverse events are the possible result of unintentional methadone overdoses, drug interactions, and methadone's cardiac toxic effects, the agency stated.

According to the alert, physicians prescribing methadone should be familiar with the drug's toxic effects and pharmacological properties and should carefully select methadone doses for pain relief, slowly titrating to an analgesic effect; avoid prescribing 40-mg dispersible tablets for pain (approved only for detoxification and maintenance treatment of narcotic addition); and closely monitor patients starting methadone treatment and those who receive a change . . . [Full Text of this Article]

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