Methadone 40mg tab

[xiphoid2010]

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We admitted a patient on methadone 30mg po tid for chronic pain. MD increased it to 40mg. I processed order with using the 40 mg tab.

The other pharmacist says she believes it can only be dispensed to patients for opioid addition. My understanding is that only applied to outpatient, and hospitals were exempt.

Anyone more experienced knows what's the exact answer? Thanks. 👍

 

[All4MyDaughter]

Doesn't apply to hospitals. Your interpretation of the law is correct. 👍

 

[xiphoid2010]

Awesome, thanks!

 

[Quiksilver]

There is a difference between maintenance and detox. At our hospital you have to dispense the correct one because there are separate DEA registration numbers for them.

 

[Old Timer]

The Official Scoop
http://www.deadiversion.usdoj.gov/pubs/advisories/methadone_advisory.htm

 

[xiphoid2010]

So let me see if I read this straight.

(1) Hospitals are exempt.
(2) 40 mg tabs are only FDA indicated for detox and maintenance.

So dispensing 40mg tab in hospitals is legal, but using it inpatient for pain constitutes as off-label use? Everyone read it that way?

 

[All4MyDaughter]

So let me see if I read this straight.

(1) Hospitals are exempt.
(2) 40 mg tabs are only FDA indicated for detox and maintenance.

So dispensing 40mg tab in hospitals is legal, but using it inpatient for pain constitutes as off-label use? Everyone read it that way?

Yes. That's how I understand it. It's off label but you can do it. At my hospital we had the 40 for inpatient use but not for the outpatient pharmacy.

 

[Quiksilver]

So let me see if I read this straight.

(1) Hospitals are exempt.
(2) 40 mg tabs are only FDA indicated for detox and maintenance.

So dispensing 40mg tab in hospitals is legal, but using it inpatient for pain constitutes as off-label use? Everyone read it that way?

and to use them for #2 requires a special DEA #

 

[xiphoid2010]

and to use them for #2 requires a special DEA #

Correct, I think is a DEA X number. I remember from jurisprudence class, the prescriber can only have 1 pt while pending application approval, then he can have max 30 patients the first year of that license, followed by 100 patients max after that.