Methadone-induced bradycardia

Methadone is commonly used in opiate detoxification in high dose. It has a molecular structure similar to verapamil and has been reported to cause similar side effects with continuous high-dose infusion. We report the case of a patient with a history of addiction and abuse of alprazolam and hydrocodone who developed sinus bradycardia after being started on oral methadone for detoxification. The potential of methadone to cause side effects similar to verapamil must be considered in any patient taking methadone.