Methadone immunologic

In a prospective study of 54 patients taking antiretroviral drugs who also took methadone and a further 154 patients who did not take methadone there were similar clinical, virological, and immunological outcomes after 12 months (52). These results support the usefulness of methadone in the management of intravenous drug users with HIV infection. 

TABLE 1.3 Immunological Techniques for the Determination of Methadone, THC, and Miscellaneous Other Drugs and Their Metabolites ... 

CT Liu, FI Adler. Immunologic studies on drug addition, I. Antibodies reactive with methadone and their use for detection of the drug. J Immunol 111 472, 1973. 

In spite of the incomplete elimination of methadone via the urine, the determination of methadone consumption does not as a rule present any problems. Several immunological and chromatographic methods are available. As EDDP is structurally very different from methadone, the immunological reagents show cross-reactivity to methadone only (Table 8-25). 

In cases of consumption of low daily doses (< 5 mg) of methadone, the use of immunological methods can lead to uncertainty with regard to patient compliance, as, directly after consumption of these low doses, methadone is excreted almost exclusively in the form of the cyclic metabolites. The two instrumental analytical methods GC/MS and HPLC/DAD also determine these metabolites with high sensitivity. GC/MS detects the principal metabolite EDDP as well as methadone itself, as shown in Fig. 8-39. The sensitivity of this analytical procedure for the determination of methadone and EDDP from blood or urine without derivatization is better than 20 ng/ml, i.e. it even extends to the subtherapeutic range [62]. Table 8-26 shows the important masses found in the... 

Fig. 8.8 Immunological cross-reactivity between methadone, morphine, and codeine demonstrated by serum IgE antibodies. Serum was from a patient showing multiple drug allergies. From Pham NH et al. Studies on the...

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