From the Guidelines
Methadone can be prescribed on an FP10 prescription form in the UK, but with important restrictions, as it is a controlled drug under Schedule 2 of the Misuse of Drugs Regulations. According to the CDC clinical practice guideline for prescribing opioids for pain - United States, 2022 1, methadone is an extended-release/long-acting (ER/LA) opioid that should be reserved for severe, continuous pain and considered only for patients who have received certain dosages of immediate-release opioids daily for at least 1 week. When prescribing methadone, clinicians should use additional caution and consider a longer dosing interval due to its unique risk profile, including cardiac arrhythmias and QT prolongation.
The prescription for methadone should include specific details, such as the form, strength, total quantity in both words and figures, dosing instructions, and installment dispensing information if applicable. The prescription should clearly state "for addiction" to distinguish its purpose when prescribed for addiction treatment. Any doctor can prescribe methadone for pain management on a standard FP10 prescription, but only doctors who hold a special license from the Home Office can prescribe methadone for addiction treatment on an FP10.
Key considerations when prescribing methadone include:
- Reserving ER/LA opioids, including methadone, for severe, continuous pain
- Considering a longer dosing interval due to methadone's unique risk profile
- Including specific details on the prescription, such as form, strength, and dosing instructions
- Ensuring patient education and close monitoring, including risk assessment for QT prolongation and consideration of electrocardiographic monitoring.
As noted in the 2017 HIVMA of IDSA clinical practice guideline for the management of chronic pain in patients living with HIV 1, methadone can provide effective analgesia when dosed carefully, but its use requires careful consideration of its risks and benefits.
From the Research
Methadone Prescription on an FP10
- Methadone can be prescribed on an FP10 prescription in the UK for the treatment of opioid dependence and chronic pain management 2.
- The safety of methadone has been a concern due to the increase in methadone-associated overdose deaths, and guidelines have been developed to promote safer use of methadone 2.
- There is no direct evidence in the provided studies that explicitly states the prescription of methadone on an FP10, but it can be inferred that methadone is a medication that can be prescribed for opioid dependence and chronic pain management 3, 4, 5, 6.
Prescription Guidelines
- The American Pain Society and the College on Problems of Drug Dependence have developed guidelines for the safer prescribing of methadone, including patient education, electrocardiography, and careful dose initiation and titration 2.
- These guidelines aim to mitigate the potential risks associated with methadone use, including overdose and cardiac arrhythmias 2.
Methadone Use in the UK
- While the provided studies do not specifically address the use of FP10 prescriptions for methadone in the UK, they do discuss the use of methadone for opioid dependence and chronic pain management 3, 4, 5, 6.
- It is essential to consult UK-specific guidelines and regulations regarding the prescription of methadone on an FP10 prescription.