In a Sweat Over Methadone

We’re nearing the end of a particularly hot summer, and patients have often asked about “sweating out” their methadone dose. They describe opioid withdrawal symptoms, and many ask if methadone is excreted in sweat.

Is methadone excreted in sweat? Yes, it is, but in very small amounts. We know this from sweat testing, a newer type of drug testing. With a sweat test, a patch is applied to the skin and left in place for varying lengths of time varying from12 hours to one week. Even with the one-week patches, the amount of methadone excreted is measured in nanograms. As a frame of reference, it takes one million nanograms to equal one milligram. In other words, sweat contains methadone in miniscule amounts, and not enough to drop the blood level of a patient maintained on methadone.

However, when people sweat, it often indicates they are being more physically active than usual, or are exerting themselves in a hotter environment. This increase in metabolism can speed the metabolism of methadone. So even though tiny amounts of methadone are found in sweat, the sweating serves as a marker of higher metabolism, which may reduce blood levels of methadone.

To further complicate things, methadone makes people sweat more, sometimes with little or no activity. All opioids can do this, but methadone seems to be particularly bad about causing sweating. Most patients don’t become tolerant to this annoying side effect, but there are ways to manage the sweating (see my blog entry from 12/29/10).

Methadone and its metabolites are primary excreted by the kidneys, but also are excreted by the bowels. Methadone is excreted in breast milk, but not in significant amounts, as well as semen. (1) Methadone and its metabolites can be found in saliva, thus the usefulness of oral swab drug testing.

  1. Gerber, Nicholas, Lynn, Robert K, “Excretion of methadone in semen from methadone addicts; Comparison with blood level,” Life Sciences, Vol. 19, Issue 6, pp 787-791
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18 responses to this post.

  1. Posted by Steve on August 20, 2011 at 8:46 pm

    Can suboxone cause sweating? Because I do every day

    Reply

  2. Posted by Steve on August 21, 2011 at 12:39 am

    Thank you for the answer. How can you stop the sweating? It just started I have been on suboxone for a year. Anybody else with that problem?

    Reply

  3. Posted by carllee on August 21, 2011 at 8:22 pm

    Steve, I certainly don’t know the answer to the stop sweating question, but it’s not just you and it’s not jus methadone. Since I’ve been on buprenorphine for the last several months, it seems as though I never stop sweating, especially with the extreme summer we’ve been experiencing here in Mississippi. I sweat a lot anyway, but I’ve definitely noticed that I don’t have to do anything except “get off the couch and out of the ac” to begin sweating profusely. I’ve also noticed a stronger body odor from myself and a definite stronger smell from my urine. As Dr. Jana has pointed out, it must be quite common with opiates. I suppose it’s a small price to pay for the benefits I get from the Subutex. It is a little embarrassing though, to be drinched with sweat and no one else is.The question always arises “what are you on?” when I’m soaked with sweat and supposed to be on the wagon. I’m just sayin. I haven’t read the blog post that Dr. Jana referred but I’m fixin to. Maybe it’ll help.

    Reply

    • I re-posted the blog entry regarding sweating.

      Reply

      • Posted by carllee on August 22, 2011 at 3:13 am

        Thanks for the re-post, though i had already gone back to the 12/2010 blog post and read it. LOL. I knew you would do that, the re-post i mean. You are so predictable when it comes to taking care of things for us. It makes me smile! You are always on top of things Dr. Jana, and I think I speak for all of us here when I say “We appreciate you!”

  4. Posted by Ryan on August 21, 2011 at 8:57 pm

    Does anyone know if Vitadone/Nutridone help with this or is it just a waste of money?! Just curious as I recently heard about them and have the issue with sweating constantly…

    Reply

    • Vitadone won’t help. It’s probably safe to take, but very expensive compared to similar vitamins. Vitadone has good marketing but not superior results compared to a one a day vitamin.

      Reply

  5. Posted by Steve on August 22, 2011 at 1:11 am

    .I have to disagree I am in a nice climate around 70 degrees and at my desk just start sweating.

    Reply

    • Posted by dbc3912 on August 22, 2011 at 2:48 am

      It is a drug. What is your blood pressure and heart rate? I mean, imagine if you just ate 10 caffeine pills. Same difference. I dunno, it just never did it to me.

      Reply

  6. Posted by Steve on August 27, 2011 at 12:01 am

    I got a crumbled batch of suboxon what should I do? If anything

    Reply

    • Take it back to your pharmacy and ask for a new batch. They should replace unused packages.

      Reply

      • Posted by dbc3912 on August 27, 2011 at 10:48 pm

        Should being the operative word. If you have a good pharmacy, they likely will without issue. If you have one of those pharmacies that don’t approve of Suboxone, they may give your some flack, thinking you are trying to pull some sort of weird scam (even if they can’t fathom what that is). The chain pharmacies seem to be the worst with treating Suboxone patients badly, though they vary and aren’t all bad.

  7. Posted by Shannon on November 10, 2015 at 1:14 am

    Cinnamon. It is the only thing that actually helps. Buy a cinnamon supplement and take it when you first start to sweat or before bed so you won’t wake up in a puddle. It works.

    Reply

  8. I really hate this side effect. And this summer I’ve noticed it worse than ever for some reason. I switched from the “cherry” pink to the orange wafers which doesnt hold as long. Does the type of methadone have any affect on side effects? Do different types secrete differently when it comes to sweat and other bodily fluids?

    Reply

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