اقتباس:HOW TO REDUCE DOSES
Given that the patient has been stable on a regular methadone dose for at least four weeks and is suitably motivated, then a reduction of approximately 10% of the daily dose may be undertaken as a trial. This should always be organised a few days ahead, as it is never an urgent decision. This allows a change of mind and delayed reductions if the patient lacks confidence. Pressure from others to reduce doses is destabilising and must be resisted.
As long as the patient tolerates the new dose, then a further 10% reduction may be taken after a further two weeks. The steady state blood level of methadone is not achieved until five to seven days after a dose change, so it is inappropriate to alter doses within the one week. A two week period therefore allows this second week to see if the lower level is tolerated.