Rhabdomyolysis and Acute Renal Failure following Methadone Abuse

Hojs, Radovan; Sinkovič, Andreja

doi:10.1159/000187076

Cited by 21 publications

(11 citation statements)

References 6 publications

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“…115 Rhabdomyolysis associated with acute renal failure has also been reported after methadone abuse. 62 Although renal recovery can be expected, long-term disability might occur as a result of potential serious complications and comorbidity. Eight patients required dialysis for an average of 14 days.…”

Section: Opioid Addiction and Renal Damagementioning

confidence: 99%

Opioids and renal function

Mercadante¹,

Arcuri²

2004

The Journal of Pain

128

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Section: Opioid Addiction and Renal Damagementioning

confidence: 99%

Opioids and renal function

Mercadante¹,

Arcuri²

2004

The Journal of Pain

128

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“…Several reports indicate a real risk of overdose for those about to commence methadone treatment, especially during the first few days of dosing (60,64,153,154,155). Drummer (140) estimated the risk of death when starting MMT to be about sevenfold higher than the risk before entering a treatment program (155).…”

Section: Methadone Treatmentmentioning

confidence: 99%

Characterization of Methadone Overdose: Clinical Considerations and the Scientific Evidence

Wolff¹

2002

Therapeutic Drug Monitoring

106

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Overdosing with methadone is a growing phenomenon in Britain and other countries due to the increase in prescription and the availability of this compound. Little is known of the circumstances surrounding methadone death due to some extent to the difficulty of defining drug-related death and also the difficulty of collecting clinical and biographical data in a predominantly illegal and marginal milieu. However, the evidence points to highest risk at night (to this end manifestations of its toxicity often go unrecognized) in those whose usual tolerance has been reduced and occurring some considerable time after ingestion. Further investigations are needed to elucidate fully the mechanism and spectrum of methadone overdose. Death from methadone is eminently preventable more so because of the long-term nature of the clinical sequelae. Indeed the key issue with methadone that sets it apart from other opioids is its potential for delayed toxicity. Consequently steps should be taken to disseminate the salient facts to all those who come into contact with the drug.

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“…One of the debates on this topic is the unclear mechanism involved in methadone-induced rhabdomyolysis and AKI (Hojs and Sinkovič 1992). Methadone may induce rhabdomyolysis indirectly, for example as a result of coma leading to compression necrosis of a dependent extremity or respiratory depression causing hypoxemia.…”

Section: Discussionmentioning

confidence: 99%

“…Methadone may induce rhabdomyolysis indirectly, for example as a result of coma leading to compression necrosis of a dependent extremity or respiratory depression causing hypoxemia. For instance, according to the studies conducted by Mittal et al Hojs et al Hsu et al and Valga-Amado et al unconsciousness causes increased muscular demand for oxygen, as well as secondary ischemia, which may cause rhabdomyolysis (Hojs and Sinkovič 1992; Hsu et al 2009; Mittal et al 2010; Valga-Amado et al 2012) (Table 1). Another explanation for an indirect cause of methadone-induced rhabdomyolysis is pulmonary edema and resultant hypoxia, which also leads to increased muscular demand for oxygen.…”

Section: Discussionmentioning

confidence: 99%

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Nephrotoxicity of methadone: a systematic review

et al. 2016

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BackgroundMethadone is commonly administered for chronic pain relief and treatment of opioid dependence. Concurrent with its increased consumption, toxicities and fatalities have increased. One of the adverse effects of opioid analgesics, including methadone, is that of nephrotoxicity. Opioids can have an effect on renal function through several different mechanisms.MethodsWe searched common bibliographical databases for the terms methadone, toxicity, poisoning, kidney, renal, and nephrotoxicity and summarize our findings in this review.ResultsMethadone can have both direct and indirect effects on the kidney. These effects include rhabdomyolysis (leading to acute kidney injury), volumetric changes, renal lipidosis and amyloidosis, kidney growth during pregnancy, and kidney transplant rejection.ConclusionImproved understanding of the effects of methadone on kidney function can promote safer and more confident use of the drug.

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Rhabdomyolysis and Acute Renal Failure following Methadone Abuse

Cited by 21 publications

References 6 publications

Opioids and renal function

Opioids and renal function

Characterization of Methadone Overdose: Clinical Considerations and the Scientific Evidence

Nephrotoxicity of methadone: a systematic review

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