title: Effects of Hemodialysis on Methadone Pharmacokinetics and QTc.
abstract: OBJECTIVE
  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.
  
  
  RESULTS
  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.
  
  
  CONCLUSIONS
  Methadone dose adjustment is not needed because of hemodialysis.
authors.affiliation: Institute of Clinical Medicine, Oslo University, Oslo, Norway; Department of Pharmacology, Oslo University Hospital, Oslo, Norway. Electronic address: uxmist@ous-hf.no.
authors.forename: Mimi Stokke
authors.initials: MS
authors.lastname: Opdal
authors.affiliation: Department of Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway.
authors.forename: Margrete
authors.initials: M
authors.lastname: Arnesen
authors.affiliation: Department of Pharmacology, Oslo University Hospital, Oslo, Norway.
authors.forename: Lill Dannevig
authors.initials: LD
authors.lastname: Müller
authors.affiliation: Department of Pharmacology, Oslo University Hospital, Oslo, Norway; Norwegian Doping Control Laboratory, Oslo University Hospital, Oslo, Norway.
authors.forename: Ingunn
authors.initials: I
authors.lastname: Hullstein
authors.affiliation: Salvation Army Hospital, Oslo, Norway.
authors.forename: Karim
authors.initials: K
authors.lastname: Sayed
authors.affiliation: Institute of Clinical Medicine, Oslo University, Oslo, Norway.
authors.forename: Odd
authors.initials: O
authors.lastname: Brørs
authors.affiliation: Department of Pharmacology, Oslo University Hospital, Oslo, Norway.
authors.forename: Marianne
authors.initials: M
authors.lastname: Kringen
authors.affiliation: Department of Nephrology, Oslo University Hospital, Oslo, Norway.
authors.forename: Solbjørg
authors.initials: S
authors.lastname: Sagedal
authors.affiliation: Institute of Clinical Medicine, Oslo University, Oslo, Norway; Department of Cardiology, Oslo University Hospital, Oslo, Norway.
authors.forename: Knut
authors.initials: K
authors.lastname: Gjesdal
authors.affiliation: Department of Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway.
authors.forename: Peter
authors.initials: P
authors.lastname: Krajci
mesh_terms: D000368:Aged; D004562:Electrocardiography; D005260:Female; D015312:Hemodialysis Solutions / Q000737:chemistry; D006801:Humans; D007676:Kidney Failure, Chronic / Q000378:metabolism / Q000628:therapy; D008133:Long QT Syndrome / Q000209:etiology; D008297:Male; D008691:Methadone / Q000493:pharmacokinetics*; D058850:Opiate Substitution Treatment / Q000379:methods*; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*; D053719:Tandem Mass Spectrometry / Q000379:methods
chemical_list: D015312:Hemodialysis Solutions; D008691:Methadone
keywords: QTc; hemodialysis; methadone; methadone maintenance treatment; pharmacokinetics; renal failure