Max dose of methadone

Grapefruit juice. Carbamazepine. Phenytonin. Rifampicin/rifampin. St Methadone 10mg q3h PRN. Max 3 doses in 24hrs. On day 4/5 – doses

Calculate starting lorazepam dose: Midazolam: Multiply current midazolam drip rate (mg/kg/h) X 0.5 = _____ mg/kg lorazepam q6h (max initial dose 0.2 mg/kg/dose q6h AND max 4 mg q6h) Weaning Methadone and Lorazepam Once stable on methadone and/or lorazepam for 24 h with no withdrawal symptoms, wean methadone and lorazepam as follows. Methadone

IV to PO Conversion: Hydromorphone IV : PO = 1 : 5; Methadone IV : PO = 1 : 0.7. Current Infusion Dose Recommended Scheduled Dosing PRN Dosing Midazolam Drip IV Lorazepam (Max Dose: 4 mg) PRN IV Lorazepam (Max Dose: 4 mg)

The methadone max dose for pain for the starting dose is 20 mg per day. In the case of elderly patients, the upper limit is 10 mg per day.

IV to PO Conversion: Hydromorphone IV : PO = 1 : 5; Methadone IV : PO = 1 IV Lorazepam (Max Dose: 4 mg). PRN IV Lorazepam (Max Dose: 4 mg). 0.06 mg

Quick Guide: Methadone Starts in the Hospital. Day 1: max daily dose 40 mg methadone. Testing prior to first dose: Urine toxicology. EKG for QTc interval. Urine

Note: seek advice from the PCU clinical staff before any increase in the dose of methadone or ketamine. Max dose is 300 mg bid. Reduce dose

Calculate starting lorazepam dose: Midazolam: Multiply current midazolam drip rate (mg/kg/h) X 0.5 = _____ mg/kg lorazepam q6h (max initial dose 0.2 mg/kg/dose q6h AND max 4 mg q6h) Weaning Methadone and Lorazepam Once stable on methadone and/or lorazepam for 24 h with no withdrawal symptoms, wean methadone and lorazepam as follows. Methadone

❑ Give Day 3 max dose. Continue protocol until reaching 60mg daily DO continue methadone or bup dosing before and after surgery.