Effects of Switching From Racemic Methadone to R-methadone on QTc Intervals

NCT ID: NCT04254731

Last Updated: 2024-04-03

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE4

Total Enrollment

10 participants

Study Classification

INTERVENTIONAL

Study Start Date

2015-05-07

Study Completion Date

2024-07-30

Brief Summary

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Effects of switching from racemic methadone to R-methadone on serum methadone concentrations and QTc intervals

Detailed Description

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Racemic methadone may prolong the QTc interval, which is associated with fatal arrhythmias. In vitro studies have shown that R-methadone has less inhibitory effect than S-methadone on the voltage-gated potassium channel current, and is thus thought to have less effect on the QTc interval.

The investigators hypothesized that switching from racemic to R-methadone would reduce the methadone serum concentration and also its effect on the QTc interval.

Conditions

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Adverse Drug Effect Drug Effect Heart Arrhythmia

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Patients included were stabilized on per os methadone maintenance treatment and had automatically ECG recorded QTc interval greater or equal to 450 ms. The patients were switched to pure R-methadone per os (half dose of the racemic methadone used). Doses, serum drug concentrations, QTc-time were recorded before and after drug switch. Serum-electrolytes (Mg, K, Ca) and opioid withdrawal symptom scale (OWS) were also measured and scored before and after drug switch.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Cross over study before and after drug switch

Stabilized on racemic methadone dose, switched to R-methadone of half racemic methadone dose. Cross over study, own control

Group Type OTHER

Same individuals treated with racemic methadone and switched to levomethadone (R-methadone)

Intervention Type DRUG

Interventions

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Same individuals treated with racemic methadone and switched to levomethadone (R-methadone)

Intervention Type DRUG

Other Intervention Names

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Drugs provided from the pharmaceutical company called DnePharma AS (Den norske Eterfabrikk ( DnE), address Karihaugen 22, Oslo, Norway, drug delivered to patient from home nurse or pharmacy

Eligibility Criteria

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Inclusion Criteria

* Stabilized on daily methadone dose
* Not using other drugs of abuse
* QTc-time recorded automatically, patient inclusion if QTc interval was greater or equal to 450 ms
* Older than 18 years
* Can sign and understand a written Consent

Exclusion Criteria

* Can not cooperate regarding observed daily drug intake
* Serious psychiatric disease
* Untreated serious somatic disease
* Pregnancy
Minimum Eligible Age

18 Years

Maximum Eligible Age

70 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Oslo University Hospital

OTHER

Sponsor Role lead

Responsible Party

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Mimi Stokke Opdal

Senior Consultant and Associate Professor of Clinical Pharmacology

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Mimi Stokke S Opdal, MD, PhD

Role: STUDY_DIRECTOR

Oslo University Hospital and University of Oslo

Peter Krajci, MD, PhD

Role: STUDY_DIRECTOR

Oslo University Hospital

Locations

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Department of Pharmacology , Oslo University Hospital

Oslo, , Norway

Site Status

Department of Pharmacology and Department of Substance Use Disorder, Oslo University Hospital

Oslo, , Norway

Site Status

Department of Substance Use Disorder, Oslo University Hospital

Oslo, , Norway

Site Status

Countries

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Norway

References

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Havig SM, Berg-Pedersen RM, Krabseth HM, Muller LD, Haugaa K, Zare HK, Gjesdal K, Krajci P, Opdal MS. Effect on QTc interval by switching from methadone to equipotent R-methadone dose in methadone maintenance treatment patients. Basic Clin Pharmacol Toxicol. 2024 Apr;134(4):519-530. doi: 10.1111/bcpt.13982. Epub 2024 Feb 3.

Reference Type BACKGROUND
PMID: 38308508 (View on PubMed)

Provided Documents

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Document Type: Study Protocol

View Document

Document Type: Informed Consent Form

View Document

Related Links

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Other Identifiers

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2012/793 REK

Identifier Type: -

Identifier Source: org_study_id

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