Dosage
Always take methadone as a doctor, pharmacist, key worker or prescriber tells you to, or follow the instructions that come with your medicine.
Dosage for heroin dependence
The amount of methadone you take depends on different things. When you start, this includes:
- the amount of heroin you're using
- whether you're using other drugs or alcohol
- a urine or saliva sample (to test for heroin and other drugs)
- your physical and mental health
- whether you have had treatment for drug dependence before
You'll usually start on 10mg to 30mg, taken once a day. This can be increased slowly, until your withdrawal symptoms and your cravings stop.
Many people then take a regular dose of between 60mg and 120mg a day. However, your dose may be different. Always follow your treatment plan.
Getting your prescription
You'll get your first prescription (or script) from your GP, or a prescriber at your drug treatment service. This may be a nurse, doctor or a pharmacist.
They'll usually ask you to choose a pharmacy to take your prescriptions to. You can pick a pharmacy that's convenient for you.
When your prescription's ready, the prescriber will contact your pharmacy to check that they can make your methadone dose for you. You'll need to collect your methadone from the same pharmacy each time.
To begin with, you'll usually visit the pharmacy every day and take your methadone there. Speak to your prescriber if that's going to be difficult.
Supervised doses
When you start your treatment, a key worker or pharmacist will usually supervise you as you take methadone.
When your doses of methadone are stable and regular, you may be able to start taking some of your doses at home. Your key worker and prescriber will talk to you about working out what's right for you.
If you have methadone at home, keep it in a safe place and away from children.
How to take methadone
Methadone for heroin dependency usually comes as a green liquid that you swallow once a day.
It's best to swallow the medicine in one go. You can have a drink of water afterwards if you like.
How long to take it for
If you're taking methadone for maintenance therapy, you'll usually take it long term, as a substitute for heroin.
If you're taking it for detox, your dose will gradually be reduced until you do not need to take it anymore. This usually takes up to 12 weeks. It can sometimes be quicker, for example if you're detoxing in hospital or residential rehab.
You will stay on methadone until you decide to come off it. When you're ready to do this, your key worker will help you to reduce your dose of methadone gradually.
Stopping methadone
It's important not to stop taking methadone suddenly or without talking to your GP or prescriber first.
If you stop taking your methadone suddenly, you'll have withdrawal symptoms. These include feeling restless or anxious, a runny nose, sweating, feeling or being sick, diarrhoea and muscle cramps.
If you want to stop taking methadone, you'll need to make a new treatment plan. Your GP, prescriber or key worker will help you to reduce your dose very gradually. This is to help prevent withdrawal symptoms.
If you forget to take it
If you take methadone at home and miss a dose, take it as soon as you remember, unless it's nearly time for your next dose. In this case, skip the missed dose and take your next one at the usual time.
Never take 2 doses at the same time. Never have an extra dose to make up for a forgotten dose.
Tell your key worker, GP or prescriber that you missed a dose. They may ask you to return the leftover liquid.
If you have supervised doses and miss a dose, go to your pharmacy or drug treatment centre as soon as you remember, as long as it's during opening hours.
If you cannot get to your pharmacy or drug treatment centre until the next day or later, they may not be able to give you any methadone. They may need to speak to your prescriber first.
It's important to take your methadone or collect your doses on the right day. Always check your treatment plan.
If you take too much
It's important to take the dose that it says in your treatment plan and prescription.
If you take too much methadone you could be at risk of an overdose.
Too much methadone may make you very sleepy, and can slow down or stop your breathing. This can be life-threatening.
It's important to get medical advice if you take more than your prescribed dose of methadone.
Immediate action required: Call 999 if:
You take more than your prescribed dose of methadone and you:
- feel very drowsy
- find it difficult to breathe
If you're with someone who's unconscious or struggling to breath after taking more than their prescribed dose of methadone:
- call 999 immediately
- give them naloxone now if you have access to it. If you have not been trained how to give it, tell the 999 call handler who will give you advice
Urgent advice: Call 111 now if:
- you take more than your prescribed dose of methadone, even if you feel well
If you need to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.
Bring the methadone packet or leaflet inside it, any remaining medicine, and any other medicines you take.
It's also important to tell your key worker or doctor that you've taken too much. This is because you will run out of methadone before you get your next supply.