Table 1.

Case reports about methadone induced rhabdomyolysis and AKI

Author	Age/gender	Methadone dose	Primary signs and symptoms	Lab parameters	Outcome
Hojs and Sinkovic (1992)	28/Male	30 mg IV	Comatose, cyanotic congenital heart disease, and shallow breathing, anuria	Urea: 124 mg/dl Creatinine: 2.18 mg/dl Myoglobin-positive urine. CK: 12,000 U/L	Discharged in good condition
Chakera (2008)	30/Male	120 mg	Unconsciousness	CK: “increased” Metabolic acidosis, anuria.	After 7 sessions of dialysis, renal function started to recover.
Hsu et al. (2009)	33/Male	150 mg/day (heroin user)	Unconsciousness	CK: 17,680 U/L, Cr: 2.9 mg/dl myoglobin: >4000	Cerebral ischemic infarction
Nanji and Douglas Filipenko (1983)	31/Male	“Large amount” of methadone	Respiratory distress, but awake	BUN: 24 mg/dl, Creatinine: 2.2 mg/dl CK: 7500 U/L.	Recovered
Gramenz et al. (2010)	Not mentioned	10-mg methadone tablets dissolved in water and injected into femoral artery	Severe pain and leg cyanosis. No unconsciousness	CK: 4208 U/L.	Responded to medical therapy
Valga-Amado et al. 2012	41/Male		Muscle weakness and widespread myalgia, Reduced consciousness	Creatinine: 2.88 mg/dl; CK: 86,000  IU/l.	Recovered
Mittal et al.	38/Male	Methadone and diazepam ingestion	Unconsciousness methadone-induced delayed posthypoxic encephalopathy	CK: 3339 IU/l BUN: 13 mg/dl Creatinine: 3.2 mg/dl (diagnosis of AKI was made).	Treated successfully with combination of steroids and antioxidants
Weston et al.	27/Male	Not mentioned	Unconsciousness	CK: 31,500 u/l Urine osmolality: 292 mosmol/l (diagnosis of AKI was made)	Full recovery
David et al. 1	24/Male	40 mg IV	Comatose, Shallow breathing, pulmonary edema	BUN: 62 mg/dl Creatinine: 3.9 mg/dl. CK: 6750 IU/l	Discharged in good condition
David et al. 2	25/Male	50 mg /IV	Apneic, comatose, pulmonary edema	BUN: 132 mg/dl Creatinine: 5.2 mg/dl CK: 190 IU /L	Died