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High Interindividual Variability of Methadone Enantiomer Blood Levels to Dose Ratios
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Methadone is used as a maintenance treatment for opiate addiction. A linear relationship with a good correlation coefficient (n=31, r=0.82, P<.001) has been calculated between methadone dose and methadone concentrations in plasma.1 Methadone is marketed as a mixture (50:50) of 2 enantiomers called (R)-methadone and (S)-methadone, but (R)-methadone accounts for nearly all of the opioid effects of racemic methadone.2 We have developed a stereospecific analytical method that allows measurement of the concentrations of (R)-methadone and (S)-methadone.3 It was used to determine the (R)-methadone and (S)-methadone trough concentrations in the serum or plasma samples from 50 addicts receiving racemic methadone therapy in steady-state conditions.
Patients and Methods
Twenty-five patients treated in our addiction ward (Lausanne, Switzerland) and 25 patients from a clinical study in Essen, Germany3 were included. Patients were treated with various doses of racemic methadone, but with an unchanged dose for at least 7 days. Methadone was administered once daily . . . [Full Text of this Article] Results
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