P & T : a peer-reviewed journal for formulary management
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Methadone HCl is used for the management of opioid addiction and chronic pain. Published reports indicate that methadone can be associated with a prolonged corrected QT (QTc) interval, especially at daily doses greater than 100 mg. The risk of this adverse effect is not always considered by health care pain specialists, who sometimes use lower doses. The objectives of this case series were to evaluate the effects of methadone on the QTc interval in patients being treated for chronic pain and to determine whether there was a correlation between dosing and the degree of QTc prolongation. ⋯ Our case series suggested that QTc intervals should be routinely monitored in patients receiving methadone and that patients should be screened before therapy is initiated. Ideally, the QTc interval should be monitored before treatment begins and during repeated intervals thereafter. On the basis of the analysis, a protocol was developed at our facility for monitoring ECGs in patients being treated with methadone for chronic pain.