Methadone disposition in patients with chronic liver disease

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Abstract
Chronic liver disease is common in methadone-maintained patients. The disposition was studied of this drug in 14 patients with biopsy-proved chronic liver disease and 5 otherwise healthy subjects receiving methadone maintenance treatment. The patients were divided into 3 groups based on the severity of liver disease, with group 1 having the most severe disease. The apparent terminal half-life of methadone was longer in group 1 than in groups 2 and 3 (moderate and mild chronic liver disease, P < 0.01) and the contrast group (P < 0.05). All other kinetic indices determined for group 1 and all kinetic indices in groups 2 and 3 were essentially the same as those in the contrast subjects or in the other patient groups. Seven patients, including all 5 in group 1, had flattened plasma methadone concentration-time curves. The maintenance dosage of methadone may not need to be changed in stable chronic liver disease.