Methadone Use in Calciphylaxis

Sheth S, DO, Dyara O, DO
Department of Anesthesiology
Medical College of Wisconsin, Milwaukee, WI

 

INTRODUCTION

Methadone is widely known as a treatment for opioid addiction1. However, methadone can also be used to treat chronic pain, as it has unique pharmacodynamic properties2. This synthetic opioid’s analgesic effects are centrally-mediated through agonism at the μ-opioid receptor, antagonism at the N-methyl-D-aspartate (NMDA) receptor, and inhibition of serotonin and norepinephrine reuptake3. Additionally, methadone’s excellent oral bioavailability and mucosal absorption, low cost, long half-life, and availability in oral, parenteral, and suppository forms make it an excellent alternative for the treatment of chronic pain4. This case report demonstrates the use of methadone as an alternative opioid choice for chronic pain control in a patient’s unique case of calciphylaxis.