Abstract
PurposeEffects of hemodialysis on pharmacokinetic properties and QTc were studied in 4 patients taking daily methadone dose of 100 mg (range, 60–120 mg). MethodsMethadone in serum, dialysate, and urine were measured by LC-MS/MS. QTc was calculated with Bazett’s formula. FindingsThe 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. ImplicationsMethadone dose adjustment is not needed because of hemodialysis.
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