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A possibility Metadon Nordic Drugs When Metadon APL disappeared from the market, many people asked for it to come back. That’s why the medication is now available again. It’s the exact same formula, with a few improvements, such as being completely alcohol-free and having a child-safe cap. The medication is still produced by APL (Apotek Produktion & Laboratorier AB) but is now called Metadon Nordic Drugs. Metadon APL has been around since 1966, when it was first manufactured by Apoteket, making it the first of its kind in the country.This means it’s a well- established and trusted medication in the treatment of opioid dependence. The product has been developed in collaboration with doctors and patients, allowing us to adapt Metadon Nordic Drugs based on feedback. For example, we’ve chosen a raspberry flavor, as this was a popular request. Metadon Nordic Drugs is included in the high-cost protection for medications and requires a prescription. To receive treatment with Metadon Nordic Drugs, you’ll need to participate in a medication-assisted treatment program, which can also provide psychosocial support. 3 This brochure is for you who have started using Metadon Nordic Drugs as part of your medication-assisted treatment. Here, you’ll find information about how the medication works and some useful tips during the treatment. The goal of methadone is to help you live a normal life and leave the drug abuse behind. Many people have tried to quit on their own or gone through other treatments without success. It’s not just about wanting to quit - your body can struggle to function without opioids, making it hard to do this alone. Medication-assisted treatment with methadone can give you the support you need, and for many, it’s the key to breaking free from addiction.
Medication-assisted treatment If you’ve been offered help through medication-assisted treatment, Metadon Nordic Drugs is one of the options available to you.Your doctor will decide which treatment is best for you, but it’s important that you share your thoughts or preferences so you can get the care that suits you best. Treatment with methadone for opioid dependence follows specific rules set by the Swedish National Board of Health and Welfare (Socialstyrelsen).This means there are certain guidelines you’ll need to follow to stay in the program. Since many others are waiting for this type of treatment, it’s important to take care of your spot and follow the rules. If you have any questions about the program, your rights, or what’s expected, talk to your clinic or check the information provided by the National Board of Health and Welfare. Why methadone? The medication Metadon Nordic Drugs helps you stop using opioids such as heroin, oxycodone, or morphine. It gives you the chance to live without these drugs and everything that comes with them.With methadone treatment, you no longer have to chase drugs every day, you avoid needles, and you reduce the risk of contracting hepatitis or HIV. If you’ve had to engage in criminal activities or prostitution to afford your drug, medication-assisted treatment with methadone is an opportunity to leave that behind. Your health will improve, and many people in medication-assisted treatment find that their relationships with family and friends get better. Some start working again or return to school to finish missed studies. Others get a driver’s license. It’s a chance to live a normal life. Methadone treatment is a well-established therapy where doses are carefully managed by doctors with the goal of helping you live as normal a life as possible. Methadone is long-acting, so you only need to take it once a day. For many, the treatment is lifelong, while others choose to try tapering off. Either way, the goal is for you to live the best and safest life possible. Benefits of medication-assisted treatment: • The treatment is provided under the Health and Medical Services Act (1982:763). • You avoid using dirty injection equipment, reducing the risk of bloodborne infections like hepatitis or HIV. • You no longer have to constantly chase drugs. • You can leave behind criminal activities and prostitution. • You increase the chance of rebuilding relationships with family and friends. • You gain better health and a sense of security. • You only need to take one dose per day. 4
5 How methadone works Methadone keeps withdrawal symptoms away for about a day.To avoid craving for the opioid you’ve been using and the withdrawal it causes, you’ll need to take Metadon Nordic Drugs every day at the correct dose, which will be decided by your doctor. With regular treatment and once-daily dosing, you can function normally without experiencing withdrawal or craving. Metadon Nordic Drugs is taken as an oral solution. Methadone has a slow onset of action, so you won’t feel high when you take it. It takes up to 4 hours to reach the full effect of a dose. Methadone must be taken by drinking it, only in the dose prescribed by your doctor. It should never be injected. Injecting methadone can cause permanent damage to your blood vessels and negative effects on your body, and there is even a risk of fatal outcomes. At the start of treatment, your doctor will adjust your dose to find the right level for your body.This stabilization process can take anywhere from a few weeks to several months. The right dose – your maintenance dose With the right dose of methadone, you can avoid opioid withdrawal, reduce cravings, and prevent bothersome side effects like drowsiness.The goal is to reach your maintenance dose as quickly and safely as possible.This process takes from a few weeks to several months. The correct methadone dose is highly individual and will be adjusted by your treatment clinic to meet your specific needs. To reach your maintenance dose safely, treatment starts with a low dose that is gradually increased. Many people feel that the medication doesn’t work well enough during the first few days of the treatment.This is usually not because your dose is too low, but because it takes three to four days for the full effect of methadone to stabilize, even if the dose isn’t increased. If you feel that the methadone isn’t “lasting” a full 24 hours and withdrawal symptoms return even after being on a steady dose for a while, talk to your doctor. Keep in mind: • If you feel high or drowsy from the methadone, let your doctor know, as your dose might be too high. • Avoid alcohol or other drugs, as taking them while you have methadone in your system increases the risk of overdose. • For methadone treatment to work effectively, you must take it regularly as prescribed by your doctor.
Where, when and how you get Metadon Nordic Drugs Where, when, and how you collect your methadone is decided by your treatment clinic. The general regulations for this are outlined in the guidelines from the Swedish National Board of Health and Welfare, which state: “When medication-assisted treatment for opioid dependence begins, the medication must, during the first three months of treatment, be prepared and dispensed by healthcare personnel at the treatment facility where the program was initiated.The patient must take the medication under the supervision of healthcare personnel at the same facility. If there are special circumstances, the doctor may decide that the medication can be prepared, dispensed, and taken at another healthcare facility.” After three months, you may be allowed more flexibility in your pickup routines if you are stable and follow the treatment plan established between you and your clinic. The responsible doctor will make this decision. Please note that medication-assisted treatment for opioid dependence may be denied if you are dependent on alcohol or other narcotic substances, and if this dependency combined with the medication-assisted treatment of opioid dependence poses a significant medical risk to you. If you have other addictions alongside your opioid dependence, talk to your doctor so you can get help instead of trying to hide it. 6
Side effects Everyone is different, and methadone affects us in different ways.The same applies to side effects. Nausea and vomiting are among the most common side effects.The side effects that may remain and are not adjusted to by the body include sweating and constipation. Some common side effects that may occur include: • Nausea, vomiting • Weight gain • Constipation • Dizziness • Fatigue • Sweating • Skin rashes • Euphoria, hallucinations • Sexual side effects, such as reduced libido, erectile dysfunction, or ejaculation issues You can read more about side effects on FASS.se. Constipation If you often experience constipation, it’s a good idea to talk to your doctor before trying laxatives or similar treatments on your own. Maybe there is a help manageing the problem. Unfortunately, constipation is common when taking methadone regularly, and it is not something the body adjusts to over time. Teeth When taking opioids, saliva production decreases, and teeth are more easily damaged since saliva helps protect the teeth. As a result, many people with opioid dependence experience poor dental health. Metadon Nordic Drugs contains sugar, but not more than a glass of orange juice. Take care of your teeth with regular brushing and mouthwash. Sex Methadone can affect sexual desire. It may decrease or disappear entirely, and men may find it more difficult to achieve an erection, but this varies from person to person. If this is a concern, you can discuss it with your doctor, as there is often help available. Note! For those who are not on legal maintenance treatment with methadone, very low doses of methadone can be lethal. 7
Withdrawal If you stop taking methadone, reduce the dose, or miss a dose, your body will react.This is because your body is accustomed to a certain level of methadone.You will then experience withdrawal symptoms. It may include: • Chills, shivering and sweating • Restlessness • Anxiety and anger • Crawling sensations in arms and legs • Sleep disturbances • Nausea and diarrhea • Runny eyes and nose • Pain in muscles, bones and joints • Yawning and sneezing Alcohol and sedatives Using alcohol, benzodiazepines, and other drugs alongside methadone is very dangerous and can cause harmful health effects, and in the worst case, be fatal. It can lead to a reduced effect of your methadone treatment. It will also impair your cognitive abilities, which in turn weakens your ability to rehabilitate. Methadone and other medications Tell your doctor if you are taking any other medications when starting treatment with methadone. Different medications can affect the effectiveness of methadone. If you have a new doctor or dentist who is not aware of your methadone treatment, make sure to tell them! It is always important that anyone treating you knows which medications you are using. If you have been prescribed other medications or purchase an over-the-counter medicine, you can always consult the pharmacy staff to see if these may affect your treatment with methadone. 8
Pregnancy If you are pregnant or planning to have a child, it is important to tell your contact person and treating doctor so that you can receive the information and support you need. Based on available experience with methadone treatment during pregnancy, there is no evidence of an increased risk of birth defects.The current recommendation is to continue methadone treatment during pregnancy.Your pregnancy and delivery should be monitored by a specialized maternal care center, which will assess the conditions during your pregnancy and delivery.The shared blood volume of the fetus and the mother may lead to a lower methadone concentration. During pregnancy, from the fetus´ perspective, it is important to avoid withdrawal and to protect against repeated and uncontrolled episodes of withdrawal and oxygen deprivation.Therefore, your dose may need to be adjusted during pregnancy. Breastfeeding Always consult your doctor and midwife when taking methadone and breastfeeding to discuss the best solution for you and your baby. Small amounts of methadone pass into breast milk while breastfeeding.The benefits of breastfeeding need to be weighed against the potential negative effects on the baby. Drug abuse can affect fertility, making it harder to conceive, and can cause irregular periods. With methadone treatment, your fertility may return. That’s why it’s important to remember to use protection if you don’t want to become pregnant. 9
Travelling The responsible doctor at each clinic will assess the conditions for your travels. Depending on the country you may be travelling to, you might need a special certificate regarding your medication. For further information, please contact your clinic. Driving Special regulations apply to holding or applying for a driver’s license when you are part of a medication-assisted treatment program.The rules are governed by the Swedish Transport Agency (Transportstyrelsen). For further information, please contact your clinic. 10
11 Taper off Note! If you’re considering stopping your methadone treatment, it’s important to talk to your doctor. It’s crucial that you taper off in consultation with your treating physician to avoid severe withdrawal symptoms.Tapering off also carries risks, and it’s very important that you are aware of them. Your tolerance to opioids decreases as soon as you begin to reduce or stop using methadone. If you relapse and use opioids, there’s a risk of overdosing on an amount that you were previously accustomed to. If you decide to taper off methadone on your own, you should do so at the pace you have agreed upon with your doctor. It’s always okay to pause the tapering process and increase the dose if you feel it’s necessary. The responsible doctor at your clinic will assess the conditions for potentially resuming the treatment. If you don´t have a tolerance to methadone, it´s easy to overdose. Just a few milligrams of methadone can be lethal for a child, a mouthful can be fatal for a teenager, and less than 20 mg can kill an adult.This also applies to individuals who have used opioids. Alcohol and sedatives increase the risk of a methadone overdose! Store your methadone out of reach of children. A single dose can be fatal. • Ensure the child-resistant cap is securely tightened. • Keep the bottle in a safe place, high up, out of sight, preferably locked away. • Inform children about the danger. Fact-checked by Martin Kåberg, Chief Physician of Psychiatry/ Addiction, Medical Officer for the Needle Exchange Program in Stockholm, Karolinska University Hospital.
Nordic Drugs AB Tel +46 40-36 66 00 E-mail: info.se@nordicpharma.com, www.nordicdrugs.se SE-MET-2400007-MAR25/ENG Important names and phone numbers Here you can write down the name and phone number to your doctor and nurse, as well as the number to your clinic. My doctor: ......................................................................................................................... My nurse/contact person: ........................................................................................... Clinic: .................................................................................................................................. Other :.................................................................................................................................. Substance with addictive properties. Narcotic drug, class II – Narcotic drug for medical use. Metadon Nordic Drugs (methadone hydrochloride) oral solution. Please read the package leaflet carefully before you start using this medicine. Used for treatment of opiate dependent patients. Should be given together with medical and psychological treatment and social rehabilitation. Do not take if you are allergic to any of the ingredients, if you use or have used monoamine oxidase inhibitors (MAOIs) within the last two weeks or if you suffer from breathing difficulties. Metadon Nordic Drugs must NOT be given to children. Talk to your doctor or pharmacist before use if you have acute asthma attacks, suffer from lung disease or breathing difficulties, have liver, kidney or heart problems, have an under-active thyroid gland or skin and tissues disorders, have an enlarged prostate gland or narrowed urethra, higher pressure inside your brain after a head injury, being treated for drug addiction or opioid overdose, have difficulty in passing urine, have abdominal pain, diarrhoea or constipation, have low oxygen level or high carbon dioxide level in the blood, taking other medicines of opioid type or medicines to relax or sleep. Can cause sleep-related breathing disorders. At any signs of addiction or dependence, speak to your doctor. Risk of poisoning in children at very low doses. Do not drink alcohol while you are taking Metadon Nordic Drugs. If you are pregnant, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Should not be taken during labour. Talk to your doctor if you are breastfeeding or thinking of breast-feeding while you are taking methadone as it may affect your baby. The ability to drive or use machinery may be severely affected until your medication has been stabilised. Your doctor will decide when you may drive or use machinery. Nordic Drugs AB, Tel 040-36 66 00, info.se@nordicpharma.com. Rev 03/2025 Nordic Swan Ecolabel, printed matter, 3041 0417
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