U.S. Department of Health & Human Services Divider Arrow National Institutes of Health Divider Arrow NCATS

Details

Stereochemistry RACEMIC
Molecular Formula C21H27NO
Molecular Weight 309.4452
Optical Activity ( + / - )
Defined Stereocenters 0 / 1
E/Z Centers 0
Charge 0

SHOW SMILES / InChI
Structure of METHADONE

SMILES

CCC(=O)C(CC(C)N(C)C)(C1=CC=CC=C1)C2=CC=CC=C2

InChI

InChIKey=USSIQXCVUWKGNF-UHFFFAOYSA-N
InChI=1S/C21H27NO/c1-5-20(23)21(16-17(2)22(3)4,18-12-8-6-9-13-18)19-14-10-7-11-15-19/h6-15,17H,5,16H2,1-4H3

HIDE SMILES / InChI

Description
Curator's Comment: description was created based on several sources, including: http://www.accessdata.fda.gov/drugsatfda_docs/label/2016/006134s040s041lbl.pdf | https://www.drugs.com/pro/diskets.html

Methadone, sold under the brand names Dolophine among others, is an synthetic opioid that is used as the hydrochloride to treat pain and as maintenance therapy or to help with detoxification in people with opioid dependence. Methadone hydrochloride is a mu-agonist; a synthetic opioid analgesic with multiple actions qualitatively similar to those of morphine. Some data also indicate that methadone acts as an antagonist at the NMDA-receptor. The contribution of NMDA receptor antagonism to methadone’s efficacy is unknown. Most common adverse reactions are: lightheadedness, dizziness, sedation, nausea, vomiting, and sweating. Avoid use mixed agonist/antagonist and partial agonist opioid analgesics with DOLOPHINE because they may reduce analgesic effect of DOLOPHINE or precipitate withdrawal symptoms.

CNS Activity

Curator's Comment: https://www.ncbi.nlm.nih.gov/pubmed/5084666

Approval Year

Targets

Targets

Primary TargetPharmacologyConditionPotency
3.51 nM [Ki]
Conditions

Conditions

ConditionModalityTargetsHighest PhaseProduct
Palliative
DOLOPHINE HYDROCHLORIDE

Approved Use

For the treatment of moderate to severe pain not responsive to non-narcotic analgesics. For detoxification treatment of opioid addiction (heroin or other morphine-like drugs). For maintenance treatment of opioid addiction (heroin or other morphine-like drugs), in conjunction with appropriate social and medical services. Note – Outpatient maintenance and outpatient detoxification treatment may be provided only by Opioid Treatment Programs (OTPs) certified by the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) and registered by the Drug Enforcement Administration (DEA). This does not preclude the maintenance treatment of a patient with concurrent opioid addiction who is hospitalized for conditions other than opioid addiction and who requires temporary maintenance during the critical period of his/her stay, or of a patient whose enrollment has been verified in a program which has been certified for maintenance treatment with methadone.

Launch Date

1947
Palliative
DOLOPHINE HYDROCHLORIDE

Approved Use

For the treatment of moderate to severe pain not responsive to non-narcotic analgesics. For detoxification treatment of opioid addiction (heroin or other morphine-like drugs). For maintenance treatment of opioid addiction (heroin or other morphine-like drugs), in conjunction with appropriate social and medical services. Note – Outpatient maintenance and outpatient detoxification treatment may be provided only by Opioid Treatment Programs (OTPs) certified by the Federal Substance Abuse and Mental Health Services Administration (SAMHSA) and registered by the Drug Enforcement Administration (DEA). This does not preclude the maintenance treatment of a patient with concurrent opioid addiction who is hospitalized for conditions other than opioid addiction and who requires temporary maintenance during the critical period of his/her stay, or of a patient whose enrollment has been verified in a program which has been certified for maintenance treatment with methadone.

Launch Date

1947
Cmax

Cmax

ValueDoseCo-administeredAnalytePopulation
548 ng/mL
60 mg 1 times / day steady-state, oral
dose: 60 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
494 ng/mL
70 mg 1 times / day steady-state, oral
dose: 70 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
40.2 ng/mL
10 mg single, oral
dose: 10 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHADONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
54 ng/mL
60 mg 1 times / day steady-state, oral
dose: 60 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
AUC

AUC

ValueDoseCo-administeredAnalytePopulation
8.54 mg × h/L
60 mg 1 times / day steady-state, oral
dose: 60 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
8.27 μg × h/mL
70 mg 1 times / day steady-state, oral
dose: 70 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
1073 ng × h/mL
10 mg single, oral
dose: 10 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHADONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
0.61 mg × h/L
60 mg 1 times / day steady-state, oral
dose: 60 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
2-ETHYLIDENE-1,5-DIMETHYL-3,3-DIPHENYLPYRROLIDINE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
T1/2

T1/2

ValueDoseCo-administeredAnalytePopulation
31.2 h
60 mg 1 times / day steady-state, oral
dose: 60 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FED
39 h
70 mg 1 times / day steady-state, oral
dose: 70 mg
route of administration: Oral
experiment type: STEADY-STATE
co-administered:
METHADONE plasma
Homo sapiens
population: UNHEALTHY
age: ADULT
sex: FEMALE / MALE
food status: UNKNOWN
39.3 h
10 mg single, oral
dose: 10 mg
route of administration: Oral
experiment type: SINGLE
co-administered:
METHADONE plasma
Homo sapiens
population: HEALTHY
age: ADULT
sex: FEMALE / MALE
food status: FASTED
Doses

Doses

DosePopulationAdverse events​
10 mg 3 times / day multiple, intravenous (starting)
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
pregnant, adult
Health Status: pregnant
Age Group: adult
Sex: F
Sources:
Other AEs: Withdrawal syndrome neonatal...
10 mg 3 times / day multiple, intravenous (starting)
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
Other AEs: Respiratory depression, Addiction...
Other AEs:
Respiratory depression (grade 5)
Addiction
QT interval prolonged (grade 5)
Sources:
20 mg single, oral (starting)
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
Other AEs: Respiratory depression, QT interval prolonged...
Other AEs:
Respiratory depression (grade 5)
QT interval prolonged
Arrhythmia (serious)
Sources:
AEs

AEs

AESignificanceDosePopulation
Withdrawal syndrome neonatal
10 mg 3 times / day multiple, intravenous (starting)
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
pregnant, adult
Health Status: pregnant
Age Group: adult
Sex: F
Sources:
Addiction
10 mg 3 times / day multiple, intravenous (starting)
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
QT interval prolonged grade 5
10 mg 3 times / day multiple, intravenous (starting)
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
Respiratory depression grade 5
10 mg 3 times / day multiple, intravenous (starting)
Recommended
Dose: 10 mg, 3 times / day
Route: intravenous
Route: multiple
Dose: 10 mg, 3 times / day
Sources:
unhealthy, adult
QT interval prolonged
20 mg single, oral (starting)
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
Respiratory depression grade 5
20 mg single, oral (starting)
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
Arrhythmia serious
20 mg single, oral (starting)
Recommended
Dose: 20 mg
Route: oral
Route: single
Dose: 20 mg
Sources:
unhealthy, adult
OverviewDrug as perpetrator​Drug as victim

Drug as victim

TargetModalityActivityMetaboliteClinical evidence
no
no
no
no
no
no
no
no
yes
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
yes
yes (co-administration study)
Comment: CYP450 inducers: concomitant administration of rifampin resulted in a marked reduction in serum methadone levels and a concurrent appearance of withdrawal symptoms; phenytoin administration resulted in an approximately 50% reduction in methadone exposure and withdrawal symptoms occurred concurrently. CYP450 inhibitors: Repeat dose administration of oral voriconazole increased the peak plasma concentration (Cmax) and AUC of (R)-methadone by 31% and 47%, respectively, in subjects receiving a methadone maintenance dose. The Cmax and AUC of (S)-methadone increased by 65% and 103%, respectively
Page: 29.0
Tox targets

Tox targets

TargetModalityActivityMetaboliteClinical evidence
PubMed

PubMed

TitleDatePubMed
Neurological aspects of perinatal narcotic addiction and methadone treatment.
1975
Methadone dose increase and abstinence reinforcement for treatment of continued heroin use during methadone maintenance.
2000 Apr
Disulfiram treatment for cocaine dependence in methadone-maintained opioid addicts.
2000 Feb
Modulating effect of alcohol use on cocaine use.
2000 Jan-Feb
Thrice-weekly versus daily buprenorphine maintenance.
2000 Jun 15
[Methadone withdrawal syndrome induced by nevirapine].
2000 Mar 18
A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence.
2000 Nov 2
Pain responses in methadone-maintained opioid abusers.
2000 Oct
[Postpartum risk factors in the development of children born to opiate-addicted mothers; comparison between mothers with and without methadone substitution].
2000 Sep
Dilated bile duct in patients receiving narcotic substitution: an early report.
2000 Sep
The effect of stimulant and sedative use on treatment outcome of patients admitted to methadone maintenance treatment.
2000 Spring
A case of a methadone-induced movement disorder.
2001 Dec
Methadone is safe for treating hospitalized patients with severe pain.
2001 Dec
Reversible spastic paraparesis induced by high-dose intravenous methadone.
2001 Feb
Sleep-disordered breathing in stable methadone programme patients: a pilot study.
2001 Mar
Effects of urine testing frequency on outcome in a methadone take-home contingency program.
2001 Mar 1
Interindividual variability of the clinical pharmacokinetics of methadone: implications for the treatment of opioid dependence.
2002
Methadone induces CCR5 and promotes AIDS virus infection.
2002 May 22
The impact of methadone induction on cardiac conduction in opiate users.
2003 Jul 15
[Development of transmural myocardial infarction in young persons with intact coronary arteries during methadone use for the treatment of heroine addiction].
2004
Relationship between prescribing and risk of opiate overdose among drug users in and out of maintenance treatment.
2004
Cost effectiveness of disulfiram: treating cocaine use in methadone-maintained patients.
2004 Apr
[Life-threatening, recurrent arrhythmia in patients on high-dose methadone treatment: torsade de pointes].
2004 Aug 30
Directly observed therapy for the management of HIV-infected patients in a methadone program.
2004 Jun 1
The effect of quinidine, used as a probe for the involvement of P-glycoprotein, on the intestinal absorption and pharmacodynamics of methadone.
2004 May
Intravenous ketamine infusion as an adjuvant to morphine in a 2-year-old with severe cancer pain from metastatic neuroblastoma.
2004 Oct
QTc interval prolongation in patients on long-term methadone maintenance therapy.
2005
Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver.
2005 Dec 12
Methadone-induced bradycardia.
2005 Jul
Dextromethorphan-induced delirium and possible methadone interaction.
2005 Mar
[Methadone and sleep apnea syndrome].
2005 Mar
Methadone-induced Torsade de pointes tachycardias.
2005 May 14
QT prolongation and torsades de pointes among methadone users: reports to the FDA spontaneous reporting system.
2005 Nov
Methadone doses of 100 mg or greater are more effective than lower doses at suppressing heroin self-administration in opioid-dependent volunteers.
2005 Oct
Methadone treatment of chronic non-malignant pain and opioid dependence--a long-term follow-up.
2006 Apr
Does naltrexone treatment lead to depression? Findings from a randomized controlled trial in subjects with opioid dependence.
2006 Jan
Bradycardia during methadone therapy in an infant.
2006 Jan
A randomized controlled trial of interim methadone maintenance.
2006 Jan
Frequency of high-risk use of QT-prolonging medications.
2006 Jun
Changes in HIV risk behaviors among patients receiving combined pharmacological and behavioral interventions for heroin and cocaine dependence.
2006 May
Patents

Sample Use Guides

Chronic pain: oral initial dose - 2.5 mg every 8 to 12 hours; Intravenous initial dose: 2.5 mg to 10 mg every 8 to 12 hours Opiate withdrawal: Initial dose - 20 to 30 mg orally; an additional 5 to 10 mg may be given orally after 2 to 4 hours if withdrawal symptoms have not been suppressed or if symptoms reappear. -Maximum initial dose: 30 mg -Maximum day 1 dose: 40 mg
Route of Administration: Other
In the presence of 1 uM methadone, the maximum 86Rb+ efflux stimulated by nicotine (Emax) was markedly reduced, but the EC50 for nicotine was altered only slightly, if at all.
Name Type Language
METHADONE
HSDB   INN   MI   VANDF   WHO-DD  
INN  
Official Name English
METHADONE [MI]
Common Name English
DIAMINON
Common Name English
PHYSEPTONE
Common Name English
6-(DIMETHYLAMINO)-4,4-DIPHENYL-3-HEPTANONE
Systematic Name English
EPTADONE
Common Name English
METHADONE [VANDF]
Common Name English
METHADONE [HSDB]
Common Name English
HEPTADONE
Common Name English
DOLOPHIN
Common Name English
IDS-NM-002
Code English
DL-METHADONE
Common Name English
PHENADONE
Common Name English
METASEDIN
Common Name English
methadone [INN]
Common Name English
3-HEPTANONE, 6-(DIMETHYLAMINO)-4,4-DIPHENYL-
Systematic Name English
Methadone [WHO-DD]
Common Name English
Classification Tree Code System Code
WHO-ATC N07BC02
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
NCI_THESAURUS C1506
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
NDF-RT N0000175684
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
WHO-ATC N02AC52
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
NCI_THESAURUS C67413
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
DEA NO. 9250
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
LIVERTOX NBK548084
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
WHO-VATC QN07BC02
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
CFR 21 CFR 862.3620
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
WHO-ESSENTIAL MEDICINES LIST 24.5
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
WHO-VATC QN02AC52
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
NDF-RT N0000175690
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
Code System Code Type Description
ECHA (EC/EINECS)
200-996-9
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
RXCUI
6813
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY RxNorm
EPA CompTox
DTXSID7023273
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PRIMARY
SMS_ID
100000091046
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PRIMARY
CHEBI
28017
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
MERCK INDEX
m7286
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PRIMARY Merck Index
NCI_THESAURUS
C62044
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
HSDB
3119
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
EVMPD
SUB08833MIG
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
DRUG BANK
DB00333
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
CHEBI
167309
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
CHEBI
6807
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
CAS
76-99-3
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
PUBCHEM
4095
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
ChEMBL
CHEMBL651
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
MESH
D008691
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PRIMARY
INN
788
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PRIMARY
DAILYMED
UC6VBE7V1Z
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
FDA UNII
UC6VBE7V1Z
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
LACTMED
Methadone
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
IUPHAR
5458
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
DRUG CENTRAL
1728
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
CHEBI
50140
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
WIKIPEDIA
METHADONE
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
PRIMARY
CAS
297-88-1
Created by admin on Fri Dec 15 15:04:46 GMT 2023 , Edited by admin on Fri Dec 15 15:04:46 GMT 2023
SUPERSEDED