Levomethadyl (Systemic)

Brand name(s): Orlaam

Precautions While Using This Medicine

Taking levomethadyl is only part of your treatment. Your doctor and your counselor at the clinic will make a treatment plan for you to follow. This plan may include seeing your counselor at the clinic regularly, attending support group meetings, and making changes in your lifestyle that will help you stay away from illegal drugs. The success of your treatment will depend on how carefully you follow your treatment plan.

This medicine will add to the effects of alcohol and other CNS depressants (medicines that slow down the nervous system, possibly causing drowsiness). Some examples of CNS depressants are antihistamines or medicine for hay fever, other allergies, or colds; sedatives, tranquilizers, or sleeping medicine; prescription pain medicine or other narcotics; barbiturates; medicine for seizures; muscle relaxants; or anesthetics, including some dental anesthetics. It is very important that you do not drink alcoholic beverages or take any CNS depressants during levomethadyl treatment unless you have been directed to do so by a doctor who knows that you are taking levomethadyl. Even if you continue to have some withdrawal symptoms and to crave narcotics for a while after levomethadyl treatment has been started, do not use illegal narcotics or other CNS depressant ``street'' drugs. Taking ``street'' drugs together with levomethadyl has caused some people to die from an overdose.

Levomethadyl may cause some people to become drowsy, especially when treatment is started or the dose is increased. Make sure you know how you react to this medicine before you drive, use machines, or do anything else that could be dangerous if you are drowsy or are not alert and clearheaded . This effect usually goes away after a few days, when your body gets used to the medicine. However, tell your counselor at your next visit to the clinic if any dose causes drowsiness that is severe enough to interfere with your activities.

Dizziness, lightheadedness, or even fainting may occur when you get up suddenly from a lying or sitting position. Getting up slowly may help lessen this problem. Also, lying down for a while may relieve dizziness or lightheadedness.

Tell all health care professionals you go to that you are taking levomethadyl. This is especially important if any kind of surgery or emergency treatment is needed. Serious side effects can occur if your health care professional gives you certain other medicines without knowing that you are taking levomethadyl.

Using narcotics such as levomethadyl for a long time can cause severe constipation. To prevent this, your counselor may direct you to take laxatives, drink a lot of fluids, or increase the amount of fiber in your diet. Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems.

Levomethadyl may cause dryness of the mouth. For temporary relief, use sugarless candy or gum, melt bits of ice in your mouth, or use a saliva substitute. However, if dry mouth continues for more than 2 weeks, check with your dentist. Continuing dryness of the mouth may increase the chance of dental disease, including tooth decay, gum disease, and fungus infections.

For women only:

• Although there may be rare exceptions, levomethadyl is not recommended for use by pregnant women. Pregnancy tests will be given once a month during treatment. If you miss any of these tests you may not be able to continue receiving levomethadyl.
• Women who may become pregnant should use effective birth control during levomethadyl treatment. If you are not sure what method of birth control will work best for you, check with your counselor at the clinic.
• If you plan to become pregnant, you should first discuss your plans with your doctor or your counselor. They can arrange for you to receive methadone instead of levomethadyl.
• If you think you have become pregnant during treatment, tell your counselor right away.

Some people may be transferred to methadone after receiving levomethadyl for a while. If you are given any take-home doses of methadone, do not take the first dose of methadone for at least 48 hours (2 days) after your last dose of levomethadyl. Taking the 2 medicines too close together may cause an overdose.

If you think you may have taken an overdose of narcotics, get emergency help right away. Taking an overdose of narcotics, or taking alcohol or CNS depressants with narcotics, may lead to unconsciousness or death. Signs of overdose include convulsions (seizures); confusion; severe dizziness, drowsiness, nervousness, restlessness, or weakness; and very slow or troubled breathing. It is very important that the emergency room doctor knows that you are physically dependent on a narcotic called levomethadyl, that using naloxone to treat your overdose is very likely to cause withdrawal symptoms, and that you will need to be watched for a long time because levomethadyl's effects last for several days. However, you may not be able to give this information to the doctor yourself. Therefore, you should direct friends and family members to give this information to the doctor, if necessary.

Last Revised: 08/06/2001

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