Updates from the Methadone Maintenance Program

New methadone formulation: Methadose®

A new commercially available methadone 10 mg/ml solution (Methadose®) was recently approved for sale in Canada for methadone maintenance therapy (MMT) and is now available for purchase by pharmacies. Methadose® at 10 mg/ml is 10 times the concentration of usual compounded methadone 1 mg/ml solution and presents a public safety risk until all stakeholders are informed and MMT prescribing and dispensing standards/guidelines are updated.

Methadose® is different than methadone in appearance, strength and handling. The BC Ministry of Health is considering PharmaCare coverage of Methadose® for MMT and is actively consulting with the College of Physicians and Surgeons of BC, the College of Pharmacists of BC, the manufacturer and other stakeholders to ensure safe and appropriate use of this new product.

The ministry expects to complete the coverage decision for this product in the fall of 2013. At the same time both colleges are updating their standards/guidelines to enable safe prescribing and dispensing of a 10 mg/ml methadone product for MMT. Further updates on the progress of the reviews will be provided as they progress. Until the reviews are completed, the currently compounded 1 mg/ml methadone solution remains the standard for prescribing and dispensing, and PharmaCare coverage.

Prescribing physicians and dispensing pharmacists should be aware of the potential for confusion and warn patients about the differences in the formulations and be sure to advise them about safe storage of Methadose®.

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