Can taking methadone cause excessive sweating?

Yes, methadone can cause excessive sweating. Dr. Burson explains how to treat excessive sweating caused by methadone here.

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Does Methadone Cause Sweating?

Yes. All opioids can cause flushing and hot sweats, but methadone is probably worse than the others. This is because when it’s used to treat opioid addiction, we want the patient to go up to a dose that blocks the opioid receptors, and the hot sweats from methadone seems to be at least partially dose-related.  Why does this happen? We don’t exactly know, but it has to do with the effects of opioids on the thermo-regulatory centers in the brain.

Excess sweating can also be caused by opioid withdrawal, so if there are other withdrawal signs or symptoms (body aches, runny nose, nausea, stomach cramps), the sweating may improve with a dose increase.  About half of all patients on methadone report unpleasant sweating, but some patients report dramatic, soaking sweats. The sweating for these patients is more than an inconvenience. These are bad enough to interfere with life.

Medications for sweating caused by methadone

There are a few prescription medications which can help this severe sweating.

  1. Clonidine, a blood pressure medication, blocks sweats to some degree in many patients.
  2. Anticholenergic medicines, so named because these drugs block the effect of the neurotransmitter acetylcholine in the involuntary nervous system, block sweating. Anticholinergics tend to dry all secretions, causing such common side effects as dry mouth and dry eyes. These medications can cause more serious side effects, so they must be prescribed by a doctor familiar with the patient’s medical history.   All of these medications have been used for excessive sweating with various degrees of success, in some patients.  Some examples of anticholinergics include:
    • oxybutynin (also used for urinary leakage)
    • bipereden (used in some Parkinson patients)
    • scopolamine (also used for sea sickness)
    • dicyclomine (used for irritable bowel syndrome)
  3. For unusually bad situations, Botox can be injected under the skin of the most affected areas, like armpits, palms and soles. Obviously, this is somewhat of a last-resort measure.

Other ways to treat methadone induced sweat

Many of the common sense things do help somewhat, like wearing loose clothing, keeping your house cool, and losing weight. Regular exercise helps some people. Talcum powder, sprinkled on the areas that sweat, can help absorb some of the moisture. Antiperspirants can be used in the underarm area, but also in any area that routinely becomes sweaty. The antiperspirant can be applied at bedtime so sweating won’t interrupt sleep. There are prescription antiperspirants, like Drysol or Xerac, but these sometimes can be irritating to the skin. Avoid spicy foods, which can also cause sweating.

Make sure the sweating isn’t coming from any other source, like an overactive thyroid, and check your body temperature a few times, to make sure you don’t have a fever, indicating the sweating could be from a smoldering infection. A trip to the doctor should include some basic blood tests to rule out medical causes other than the dose of methadone.

About the author
Jana Burson M.D. is board-certified in Internal medicine, and certified by the American Board of Addiction Medicine. After practicing primary care for many years, she became interested in the treatment of addiction. For the last six years, her practice has focused exclusively on Addiction Medicine. She has written a book about prescription pain pill addiction: "Pain Pill Addiction: Prescription for Hope." Also see Dr. Burson's blog here.
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