Switching to levomethadone improves methadone-induced hyperhidrosis: A case report

J Addict Dis. 2026 Jan-Mar;44(1):101-105. doi: 10.1080/10550887.2024.2443696. Epub 2025 Feb 5.

Abstract

Methadone maintenance therapy is the cornerstone of treatment for heroin addiction. Hyperhidrosis is a common and often-overlooked side effect of methadone. Different medications, such as antihistamines and anticholinergic drugs, have been reported to be effective against opioid-induced sweating, but there is no standardized therapy. A 51-year-old patient under methadone maintenance therapy reported long-standing hyperhidrosis, which worsened each time the methadone dosage was increased. After substituting methadone with levomethadone, while maintaining equivalent dosages, the patient reported a stark reduction in sweating. Therefore, levomethadone could be a promising alternative for patients in methadone maintenance therapy who suffer from methadone-induced hyperhidrosis.

Keywords: Methadone; case report; hyperhidrosis; levomethadone; opioid.

Publication types

  • Case Reports

MeSH terms

  • Analgesics, Opioid* / adverse effects
  • Heroin Dependence* / drug therapy
  • Heroin Dependence* / rehabilitation
  • Humans
  • Hyperhidrosis* / chemically induced
  • Hyperhidrosis* / drug therapy
  • Male
  • Methadone* / administration & dosage
  • Methadone* / adverse effects
  • Methadone* / therapeutic use
  • Middle Aged
  • Opiate Substitution Treatment* / adverse effects
  • Opiate Substitution Treatment* / methods

Substances

  • Methadone
  • Analgesics, Opioid