METHADONE AND NAUSEA

[Lulubean]

I am a 68 year old who has been treated for many years with Sinemet (carbidopa/levadopa) for my RLS, which of course has led to augmentation. I have found a new doctor (in Virginia, US), who is on the medical advisory board of the RLS Foundation. He began the switchover from Sinemet to methadone last week by having me add 2.5mg methadone (2.5 mg/day taken in evening) to my usual treatment doses of Sinemet. We’ve determined to take the titration of methadone very slowly and the reduction of Sinemet also very slowly. He said it could take 6 months or longer — as long as I need.

After my very first dose of methadone, I became extremely and continuously nauseous. I never vomited, but came very close. The only way I could manage was to lie in bed. After 5 days/doses of the methadone, my doc took me off of it due to the unmanageable nausea. We will consider other treatment options at my next appointment. Meanwhile, I have not taken methadone for the last 4 nights and I am STILL so nauseous that I cannot be on my feet for very long without then needing to lie down again.

Has anyone had a similar experience? My doc said he’s never treated anyone with such a small dose of methadone having such a severe reaction. Now I wonder if it’s even the methadone. I’ve made no other changes in habits or meds. Your experiences please.

[SueJohnson]

One of the side effects of opioids can be vomiting and stopping it leads to withdrawal even after only taking it for 5 days and you can still vomit for a few days after stopping it but it certainly should stop very soon.

[Lulubean in reply to SueJohnson]

Thanks for the encouragement, Sue. I’m beginning to feel discouraged by all this.

[ChrisColumbus]

I remember that Joolsg had bad nausea when first on buprenorphine, and looking back I see she found that taking medical cannabis oil with 20% THC solved her issue. Otherwise you might find that ondansetron (Zofran) helps.

Whether it was the methadone or not, I hope that this torture soon ends for you. Good luck.

[Lulubean in reply to ChrisColumbus]

Thank you, ChrisColumbus. I will speak to my doc about both of these options. He originally said no to Zofran because of its ability to prolong the “QT interval” (something to do with electrical impulses of the heart). I am under the care of a cardiologist as well. It’s never a straightforward and simple fix, is t? Appreciate the encouragement.

[Joolsg]

Yes. I was bedridden for days with extreme nausea on Buprenorphine.BUT - it stopped ALL my RLS.

I had already been through withdrawal and was off dopamine agonists for years.

As it was my 'last chance saloon' I was determined to find a solution to the extreme nausea.

I used my medical cannabis (Oil with 20% THC) as I recalled that cancer chemo patients used cannabis to prevent nausea. I used 0.3ml at night before bed and tiny 0.1ml doses during the day if needed.

It stopped the nausea.

Otherwise, your doctor should have tried Zofran.

The nausea does tend to settle after a few weeks.

You can try reducing Sinemet with the help of tramadol or oxycodone OR get some cannabis or zofran and try again.

[Lulubean in reply to Joolsg]

Thanks Joolsg. I’ll talk to my neurologist about these varied options. He originally said no to Zofran because of its ability to prolong the “QT interval” (something to do with electrical impulses of the heart). I am under the care of a cardiologist as well.

[SueJohnson in reply to Lulubean]

A number of medicines for cardiology problems can make RLS worse and I may be able to give you safe substitutes .

In fact many medicines and OTC supplements can make RLS worse. If you are taking any and you list them here, I can tell you if any make RLS symptoms worse and if so may be able to give you a safe substitute. I have a list of more than 300 medicines and OTC supplements that make RLS worse and have safe alternatives for most of them.

[BabyBlue999]

Hi Lulu, I can’t help really. I ’ve been on Methadone for over a year now eventually on 10mg x daily with no affects at all. So sorry you’re feeling so bad, this medication had improved my life immensely, I pray you will find relief very soon. God bless sweetheart XX

[Lulubean in reply to BabyBlue999]

Thanks BabyBlue999. I had so hoped/believed that methadone would be my relief. I’m not giving up yet. God bless you also!

[wairoa36]

Hello. I am sorry you have had such a miserable . It doesn’t seem fair. I have to say I am 88 and started on Methadone over 2 years ago and had no issues with it at all. It was a lifesaver for me. I hope you can find something that cause you no prot. Best of luck. Wairia36

[JustVisiting23]

I had a somewhat similar experience. I transitioned from Sinemet to Methadone, and was troubled by terrible nausea. I was promptly prescribed Zofran which I had to use for about a week, in decreasing doses. I also supplemented with occasional marijuana. The nausea fully resolved and I have not required any additional treatment for nausea, even with up to 20mg/day of Methadone.

[Lulubean in reply to JustVisiting23]

So encouraging, JustVisiting23! My neurologist originally said no to Zofran because of its ability to prolong the “QT interval” (something to do with electrical impulses of the heart). I am under the care of a cardiologist as well. But I’ll revisit the Zofran with him. Thanks!

[Joolsg in reply to Lulubean]

fda.gov/drugs/drug-safety-a...

The warning was in relation to intravenous 32ml zofran. I think your cardiologist will probably confirm it's safe to take a short course of zofran to enable you to take the methadone to get off sinemet.

[Lulubean in reply to Joolsg]

Thanks, I hope so.

[JustVisiting23 in reply to Lulubean]

Difficult decision, but quality of life is so awfully impacted by RLS, I’d be tempted to try Zofran and revisit Methadone. Let us know how things went.

[teakabeagle]

Everyone is different in their tolerance. You have to go lower to the lowest dose that controls your symptoms and use Zofran or THC to control nausea. It should go away. I had similar reaction to Buprenorphine. Found the “sweet spot “ at .5 mg. I still had nausea but no vomiting which I treated with Zofran if needed. Took about 5 weeks , but it slowly resolved.

[love60cats]

I am so saddened to hear of your issues with taking a certain medication that was supposed to be helpful to you. I pray that your doctor will be able to do something more to help you with restless leg syndrome. I have restless and I have been for pramipexole for years. It is helpful for the most part, but of course there are days when it slipped through the cracks. I am sorry to hear that you’re experiencing all of these issues.

[Lulubean in reply to love60cats]

Thank you so much, love60cats. I hope and pray for a cure for this life-changing condition — for all of us.

[love60cats in reply to Lulubean]

I do as well. I feel that prayer is our most helpful defense. I'm praying. Hope you are too!