methadone - with food or without?

[Mongolia2020]

does anyone know if the bioavailability of opioids are affected by food? Should they be taken with a meal, or some time after?

[ChrisColumbus]

I can't really help on this one, so hope others will know.

I've checked medication guides with two brands of methadone and no recommendations are made, but both reference nausea and vomiting amongst possible side effects. One guide to oxycodone suggested that you may take it with or without food, but that if you have nausea it may help to take it with food. All other opioid guides I've found quickly say 'with or without food'. And I've not as yet come across any studies on the subject.

I note that you've been on methadone since February so hopefully you are past the stage where you might have suffered any food-related side effects.

Sorry that I can't find any other guidance or help more.

[Mongolia2020 in reply to ChrisColumbus]

I always wait for an hour after dinner and I have been wondering if I can take it with dinner in the event we have a late dinner. I have tried both but am as yet unable to determine any cause for one night having 8 hours sleep annd annother 4.

[Jumpey in reply to Mongolia2020]

I haven't used methadonebut have used opiods for rls for many years and haven't noticed any relationship between eating and effectiveness. I'm thinking of trying methadone.What is your experience of side effects?

[Mongolia2020 in reply to Jumpey]

Hi Jumpey

I started on methadone following augmentation and withdrawal from DAs causing severe rls and zero sleep for days on end, and after gabapentinoids failed and the maximum dose of codeine was not enough to control my symptoms enough to allow sleep.

For me, methadone causes severe constipation which I am controlling with 2 x laxsol tablets twice a day, plus adding pears to my diet. I initially tried prunes and figs but was concerned about suphites in them as sulphites seem to be a trigger for my rls.

The methadone Initially also made me nauseous, I had no appetite, and I fell asleep after every meal and whenever I went in the car ( I wasn’t driving due to my severe sleep deprivation). I just felt “yuk”, as though I was putting poison in my body.

I had to titrate my dose very slowly up from a starting dose of 2.5 mg. After 10 days 5 mg, and I felt so bad I reduced again to 2.5 mg, then 3.75, then 5 mg, then 6.25, then 7.5, 8.75 and finally to 10 mg. I waited 10 days between each increase to start, then a month for the last couple of increases.

At each increase, I got a corresponding increase in sleep.

My body has become used to the methadone to some degree. I have lost 10 kg which is fine but I don’t want to keep loosing weight. I am no longer nauseous but my appt is still reduced. I am no longer sleeping during the day but I go to bed often at 8 pm. I have lost some of my drive and energy. But I CAN SLEEP. And that is just heavenly.

[Jumpey in reply to Mongolia2020]

Thanks so much for sharing your story with this very difficult disease.

[TheDoDahMan]

Just as a data point for you: I've been taking 10mg methadone per day for 5 years without any regard to when I eat, and have not noticed any effect one way or the other.

[Mongolia2020 in reply to TheDoDahMan]

Thanks for that information 👍