Certified Hospice and Palliative Assistant (CHPNA) Practice Test

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What is the starting oral dose for methadone?

5-10 mg every 8 hours
2.5-5 mg every 8 hours
10-20 mg every 12 hours
1-2 mg every 6 hours

The correct answer is: 2.5-5 mg every 8 hours

The starting oral dose for methadone typically ranges from 2.5 to 5 mg every 8 hours. This dosage is aligned with guidelines for initiating treatment, which emphasize a cautious approach, especially in opioid-naïve patients or those who have not been on long-term opioid therapy. Starting at a lower dose helps to minimize the risk of opioid-related adverse effects, such as sedation or respiratory depression, while allowing for careful titration based on the patient’s response to the medication. Clinicians often begin with this conservative dosing to adjust for individual factors such as age, renal function, and concurrent medications that can affect methadone metabolism. Other choices suggest higher starting doses that may not align with recommended practices for initiating methadone therapy, particularly in vulnerable populations who may have heightened sensitivity to opioids.