Clinical therapeutics · 2015
Effects of Hemodialysis on Methadone Pharmacokinetics and QTc.
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Opdal Mimi Stokke, Arnesen Margrete, Müller Lill Dannevig, Hullstein Ingunn, Sayed Karim, Brørs Odd, Kringen Marianne, Sagedal Solbjørg, Gjesdal Knut, Krajci Peter
Аннотация
PURPOSE: Effects of hemodialysis on pharmacokinetic properties and QTc were studied in 4 patients taking daily methadone dose of 100 mg (range, 60-120 mg).
METHODS: Methadone in serum, dialysate, and urine were measured by LC-MS/MS. QTc was calculated with Bazett's formula.
FINDINGS: The serum Cmin methadone level was 1124 nmol/L (range, 547-1581 nmol/L). Methadone dialysate clearance was 17.1 mL/min (range, 13.7-20.6 mL/min). Total loss in dialysate was 2.30% (range, 1,25-3,70%) of daily methadone intake. QTc increased from 391 msec (range, 369-406 msec) to 445 msec (range, 407-479 msec), independently of serum methadone level, which may be explained by normalization of serum electrolytes.
IMPLICATIONS: Methadone dose adjustment is not needed because of hemodialysis.
METHODS: Methadone in serum, dialysate, and urine were measured by LC-MS/MS. QTc was calculated with Bazett's formula.
FINDINGS: The serum Cmin methadone level was 1124 nmol/L (range, 547-1581 nmol/L). Methadone dialysate clearance was 17.1 mL/min (range, 13.7-20.6 mL/min). Total loss in dialysate was 2.30% (range, 1,25-3,70%) of daily methadone intake. QTc increased from 391 msec (range, 369-406 msec) to 445 msec (range, 407-479 msec), independently of serum methadone level, which may be explained by normalization of serum electrolytes.
IMPLICATIONS: Methadone dose adjustment is not needed because of hemodialysis.