The purpose of this study is to learn more about how the study drug, methadone, prescribed by an infant's or child's physician as part of standard medical care, is processed in children and young adults. While this drug is used extensively in infants and children, it has not been extensively studied in this population. Physicians do not have very much information on how long it takes for methadone to be removed from the blood circulation and passed out of the body. Physicians need more information to guide how much and how often we should give methadone to children/young adults to ensure they get the maximum effect with the minimum amount of drug. During this research study, the study team will collect information about how this drug is processed in infants and children.
A total of approximately 24 to 36 infants and children will participate in this study. This study will be done at five medical centers in the United States. Treatment will be prescribed by the infant or child's doctor and not by the study team. Participants will be divided into 3 groups based on age, ages 3 months to 2 years, ages 2 to 6 years, and ages 6 to 18 years. There will be approximately 8 to 12 participants enrolled in each group. Additionally, at least 6 overweight or obese participants between ages 2-18 years will be included in this study. Information collected from each subject's routine medical care will include: * Participant gender, date of birth, race and ethnicity * Pertinent medical history * Laboratory results (blood count and chemistries) from routine testing ordered by the infant or child's regular doctor * Medications of interest the child was given within the 72 hours prior to first dose of methadone administered after consent * Time and dose of methadone administered to the child up to 14 days prior to enrollment Study specific information collected will include: * Blood sample collection to measure level of methadone * Baseline WAT-1 score (sedation withdrawal assessment of the infant or child used to assess symptoms the child/infant may experience when opioid drugs are discontinued). The duration of the study will be up to 10 days, comprised of a maximum 5 day treatment period a 5 day observation period.
Study Type
OBSERVATIONAL
Enrollment
26
To determine the PK of enteral methadone in children \> or = 90 days and \<18 years treated for opiate withdrawal per routine medical care.
All Children's Hospital
St. Petersburg, Florida, United States
Children's Mercy Hospital
Kansas City, Kansas, United States
C.S. Mott Children's Hospital
Ann Arbor, Michigan, United States
Duke University Medical Center
Durham, North Carolina, United States
Medical University of South Carolina
Charleston, South Carolina, United States
PK Parameters after multiple doses of enteral methadone
* Apparent oral clearance * Apparent oral volume of distribution * Area under the curve * Absorption rate constant
Time frame: Maximum of 7 PK samples based on dosing schedule collected over a 5 day period
PK of methadone's primary metabolite EDDP
Time frame: Maximum of 7 PK samples based on dosing schedule collected over a 5 day period
PK of R- and S-enantiomers of methadone
Time frame: Maximum of 7 PK samples based on dosing schedule collectes over a 5 day period
Correlation between plasma and DBS samples
Time frame: Maximum of 7 PK samples based on dosing schedule collected over a 5 day period
Correlation between plasma and scavenge samples
Time frame: Maximum of 7 PK samples based on dosing schedule collected over a 5 day period
Influence of CYP3A4 and CYP3B6 genetic polymorphisms on methadone PK
Time frame: Maximum of 7 PK samples based on dosing schedule collected over a 5 day period
Methadone pharmacodynamics using the WAT-1
Time frame: Maximum of 7 PK samples based on dosing schedule collected over a 5 day period
Adverse events
Time frame: Study days 1-5 and observational days 6-10
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