Indications And Dose
Severe pain ▶BY MOUTH, OR BY SUBCUTANEOUS INJECTION, OR BY INTRAMUSCULAR INJECTION ▶Adult: 5–10 mg every 6–8 hours, adjusted according to response, on prolonged use not to be given more frequently than every 12 hours Adjunct in treatment of opioid dependence ▶BY MOUTH USING ORAL SOLUTION ▶Adult: Initially 10–30 mg daily, increased in steps of 5–10 mg daily if required until no signs of withdrawal nor evidence of intoxication, dose to be increased in the first week, then increased every few days as necessary up to usual dose, maximum weekly dose increase of 30 mg; usual dose 60–120 mg daily Adjunct in treatment of opioid dependence if tolerance low or not known ▶BY MOUTH USING ORAL SOLUTION ▶Adult: Initially 10–20 mg daily, increased in steps of 5–10 mg daily if required until no signs of withdrawal nor evidence of intoxication, dose to be increased in the first week, then increased every few days as necessary up to usual dose, maximum weekly dose increase of 30 mg; usual dose 60–120 mg daily Adjunct in treatment of opioid dependence if tolerance high (under expert supervision) ▶BY MOUTH USING ORAL SOLUTION ▶Adult: Initially up to 40 mg daily, increased in steps of 5–10 mg daily if required until no signs of withdrawal nor evidence of intoxication, dose to be increased in the first week, then increased every few days as necessary up to usual dose, maximum weekly dose increase of 30 mg; usual dose 60–120 mg daily Cough in palliative care ▶INITIALLY BY MOUTH USING LINCTUS ▶Adult: 1–2 mg every 4–6 hours, (by mouth) reduced to 1–2 mg twice daily, use twice daily frequency if prolonged use DOSE EQUIVALENCE AND CONVERSION ▶See buprenorphine p. 468 for dose adjustments in opioid substitution therapy, for patients taking methadone who want to switch to buprenorphine. l UNLICENSED USE Methadone hydrochloride doses for opioid dependence in the BNF may differ from those in the product literature.
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