When This Medicine Should Not Be Used:
This medicine is not right for everyone. Do not use it if you had an allergic reaction to methadone, or if you have severe breathing problems or paralytic ileus.

How to Use This Medicine:
Liquid, Tablet, Tablet for Suspension

• Take your medicine as directed. Your dose may need to be changed several times to find what works best for you.
• Measure the oral liquid medicine with a marked measuring spoon, oral syringe, or medicine cup.
• Mix the oral concentrate with 2 tablespoons of liquid (unless your doctor tells you differently). Drink the medicine right away.
• Mix the tablet for suspension with water or another liquid, then drink the mixture right away. Do not swallow the tablet, and do not use it without mixing it in liquid first.
• Swallow the tablet whole. Do not crush, break, chew, or dissolve it.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose:
  
  • For pain: Take a dose as soon as you remember. If it is almost time for your next dose, wait until then and take a regular dose. Do not take extra medicine to make up for a missed dose.
  • For narcotic drug addiction: If you miss a dose, take your next dose the following day as scheduled.
• Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Store the oral liquid at room temperature or in the refrigerator. Do not freeze.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how methadone works. Tell your doctor if you are also using any of the following:
  
  • St John's wort, desipramine, didanosine, rifampin, telaprevir, voriconazole
  • Medicine to treat HIV or AIDS, medicine to treat seizures (such as carbamazepine, phenytoin, phenobarbital), a diuretic (water pill), blood pressure medicine, medicine to treat heart rhythm problems
  • An MAO inhibitor (MAOI) within the past 14 days
• Do not drink alcohol while you are using this medicine.
• Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol. Tell your doctor if you are also using buprenorphine, butorphanol, nalbuphine, or pentazocine.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, heart disease, heart rhythm problems (such as long QT syndrome), breathing or lung problems (such as asthma or COPD), gallbladder problems, pancreas problems, stomach or bowel problems, or trouble urinating. Tell your doctor if you have a history of head injury, brain tumor, seizures, depression, or alcohol or drug abuse.
• This medicine may cause the following problems:
  
  • High risk of overdose, which can lead to death
  • Heart rhythm problems
  • Respiratory depression (serious breathing problem that can be life-threatening)
• This medicine can be habit-forming. Do not use more than your prescribed dose. Call your doctor if you think your medicine is not working.
• Do not stop using this medicine suddenly. Your doctor will need to slowly decrease your dose before you stop it completely.
• This medicine may make you dizzy, drowsy, or lightheaded. Do not drive or do anything else that could be dangerous until you know how this medicine affects you. Sit or lie down if you feel dizzy. Stand up carefully.
• This medicine may cause constipation, especially with long-term use. Ask your doctor if you should use a laxative to prevent and treat constipation.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blue lips, fingernails, or skin
• Extreme dizziness or weakness, shallow breathing, slow or uneven heartbeat, sweating, seizures, cold or clammy skin
• Fast, pounding, or uneven heartbeat
• Severe confusion, lightheadedness, dizziness, fainting
• Severe constipation, stomach pain, or vomiting
• Trouble breathing or slow breathing

If you notice these less serious side effects, talk with your doctor:

• Mild constipation, nausea, or vomiting
• Mild sleepiness or tiredness

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088