Methadone Linked to Adverse Cardiac Events

Primary care patients prescribed methadone for pain have a greater risk of adverse cardiac events than those not taking the drug, researchers reported. 

In order to identify the relationship between treatment of pain with methadone and adverse cardiac events, researchers conducted a retrospective cohort study of 1246 patients 18 years and older taking methadone for pain management in 2010. 

Patients were either categorized as “chronic” or “non-chronic” users of methadone, and the primary outcomes over the 12-month study were cardiac events, risk for cardiac events, or neither.

Of the 1246 participants, 2.4% (30) had an adverse cardiac event, 50.4% (628) were at risk for an event, and 47.2% (588) had no risk or event. 

The instance of events was similar between chronic and non-chronic users (P> 0.05) and age, as well as dosage of 100 mg/day or higher had the greatest influence on increasing risk (odds ratio = 6.18; 95% CI = 1.08–35.45).

“Nevertheless, the one-year rate of methadone-related adverse cardiac events we identified was low,” researchers concluded.

“Therefore, health care practitioners should be aware of risk factors for cardiac events in their patients and provide appropriate monitoring when prescribing methadone for pain management.”

–Michael Potts

Prince LC, Wobeter B, Delate T, Kurz D, Shanahan R.  Methadone for Pain and the Risk of Adverse Cardiac Outcomes [published online ahead of print January 31, 2014].  doi:10.1016/j.jpainsymman.2013.09.021