The effects of racemic d,l-methadone and l-methadone in substituted patients—a randomized controlled study

Physical and mental health in severe opioid‐dependent patients within a randomized controlled maintenance treatment trial

“…In Germany, l‐methadone was initially approved for maintenance treatment, followed in 1994 by the approval of the racemic d,l‐methadone. In maintenance treatment, d,l‐methadone and l‐methadone can be replaced by each other at a 2 : 1 ratio [29].…”

Methadon und Levomethadon – Dosierung und Nebenwirkungen

“…Aktuell nehmen etwa 77 400 Patienten am Opiatsubstitutionsprogramm teil [9], allein in Berlin wurden im Jahr 2011 5032 Personen als substituiert an die Ärztekammer gemeldet. Derzeit ist das razemische (dextro-, levo) d,l-Methadon, im klinischen Gebrauch als Methadon bezeichnet, die am häufigsten verordnete Substanz zur Opiatsubstitution [10]. Aufgrund der umfangreichsten Datenlage und breiten klinischen Erfahrungen [11] sowie der niedrigeren Kosten gegenüber Levomethadon, wird vor allem Methadon zur Substitution opiatabhängiger Patienten empfohlen [12,13].…”

Cardiovascular effects of a proprietary l-methadone/fenpipramide combination (Polamivet) alone and in addition to acepromazine in healthy Beagle dogs

“…Different human studies use a 1:2 dose ratio when comparing opioid receptor effects of l ‐methadone and racemic methadone (Judson et al. 1976; Verthein et al. 2005).…”

“…When comparing the cardiovascular effects observed after 0.5 mg kg )1 L-methadone/fenpipramide IV to the cardiovascular effects of racemic methadone, which is the only available form in most countries, differences in dose effects have to be considered. Different human studies use a 1:2 dose ratio when comparing opioid receptor effects of L-methadone and racemic methadone (Judson et al 1976;Verthein et al 2005). In healthy mongrel dogs racemic methadone reduced the CI at 1 mg kg )1 -a comparable dose to the 0.5 mg kg )1 L-methadone used in the current study -for the whole study period of 120 minutes and even at a lower dose of 0.5 mg kg )1 racemic methadone, CI was decreased for 60 minutes (Maiante et al 2009).…”