Sunday, December 07, 2008

Cardiac precautions for methadone prescribing

Some guidelines are finally out, issued by the American College of Physicians. Medscape provides a summary here. Among the recommendations:

Recommendation 1 (Disclosure): When clinicians prescribe methadone, they should inform patients about arrhythmia risk.

Recommendation 2 (Clinical History): Clinicians should ask patients about any history of structural heart disease, arrhythmia, or syncope.

Recommendation 3 (Screening): All patients should have a pretreatment electrocardiogram (ECG) to measure QTc interval and a follow-up ECG within 30 days and each year.

I wonder how many people are actually doing this. I started harping about it way back here.

1 comment:

Joe 36 yr old male said...

I've been Rx'd Methadone 10mg pills. 80mgs per day for a few years from Univ of Penn Ctr for Anestisia & Pain Mgmt. Never once did they bring up possible heart trouble or to go get an EKG. Two months back I moved & switched Pain Mgmt Doctors. My new Dr. alerted me to your study & ordered an EKG. I am a research oriented person & have concluded that Methadone is by far the best Rx for me & the mgmt of my pain however your internet post & my most recent Dr's orders have me concerned. Thank you for bringing this to light. Joe 36 year old male. On Methadone for Pain for about 3 years.