Methadone Hydrochloride has 33 known drug interactions based on U.S. FDA drug labeling data. Of these, 1 are contraindicated combinations that should be avoided entirely. 22 are classified as major interactions requiring close medical supervision. Notable interactions include combinations with Mixed Agonist/Antagonist And Partial Agonist Opioid Analgesics, Alcohol, Carbamazepine. Patients taking Methadone Hydrochloride should inform their healthcare provider of all current medications — including over-the-counter drugs and supplements — to avoid potentially harmful combinations. Data sourced from OpenFDA and the NIH National Library of Medicine.
- Total
- 33
- Contraindicated
- 1
- Major
- 22
- Moderate
- 1
Contraindicated (1)
- Methadone Hydrochloride + Mixed Agonist/Antagonist And Partial Agonist Opioid Analgesics— May reduce analgesic effect of methadone or precipitate withdrawal symptoms. Avoid concomitant use.
Major (22)
- Methadone Hydrochloride + Alcohol— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
- Methadone Hydrochloride + Carbamazepine— CYP3A4 and CYP2C19 inducer that decreases methadone plasma concentration, reducing efficacy and causing withdrawal sympt…
- Methadone Hydrochloride + Erythromycin— CYP3A4 inhibitor that increases methadone plasma concentration, resulting in increased opioid effects and risk of fatal …
- Methadone Hydrochloride + Fluconazole— CYP3A4 inhibitor that increases methadone plasma concentration, resulting in increased opioid effects and risk of fatal …
- Methadone Hydrochloride + Fluvoxamine— SSRI and CYP2C19/CYP3A4 inhibitor that increases methadone plasma concentration, resulting in increased opioid effects a…
- Methadone Hydrochloride + Gabapentin— CNS depressant; concomitant use increases risk of respiratory depression, profound sedation, coma, and death.
- Methadone Hydrochloride + Ketoconazole— Azole antifungal and CYP3A4 inhibitor that increases methadone plasma concentration, resulting in increased opioid effec…
- Methadone Hydrochloride + Mao Inhibitors— Inhibition of CYP3A4 increases methadone plasma concentration, resulting in increased opioid effects and risk of fatal o…
- Methadone Hydrochloride + Monoamine Oxidase Inhibitors (Maois)— Can potentiate the effects of methadone. Avoid concomitant use or within 14 days of stopping MAOI treatment.
- Methadone Hydrochloride + Muscle Relaxants— CNS depressant effect increases risk of respiratory depression, profound sedation, coma, and death.
- Methadone Hydrochloride + Nitrazepam— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
- Methadone Hydrochloride + Other Anticholinergic Agents— Concomitant use increases risk of respiratory depression, profound sedation, coma, and death due to additive CNS depress…
- Methadone Hydrochloride + Phenobarbital— CYP3A4, CYP2B6, CYP2C19, and CYP2C9 inducer decreases methadone plasma concentration, resulting in decreased efficacy or…
- Methadone Hydrochloride + Phenytoin— CYP3A4 and CYP2C19 inducer that decreases methadone plasma concentration, reducing efficacy and causing withdrawal sympt…
- Methadone Hydrochloride + Pregabalin— CNS depressant; concomitant use increases risk of respiratory depression, profound sedation, coma, and death.
- Methadone Hydrochloride + Rifampin— CYP3A4 inducer that decreases methadone plasma concentration, reducing efficacy and causing withdrawal symptoms, with ri…
- Methadone Hydrochloride + Ritonavir— Protease inhibitor and CYP3A4 inhibitor that increases methadone plasma concentration, resulting in increased opioid eff…
- Methadone Hydrochloride + Sedatives— CNS depressant effect increases risk of respiratory depression, profound sedation, coma, and death.
- Methadone Hydrochloride + Sertraline— SSRI and CYP2D6 inhibitor that increases methadone plasma concentration, resulting in increased opioid effects and risk …
- Methadone Hydrochloride + St. John'S Wort— CYP3A4, CYP2B6, CYP2C19, and CYP2C9 inducer decreases methadone plasma concentration, resulting in decreased efficacy or…
- Methadone Hydrochloride + Topical Local Anesthetics— CNS depressant effect increases risk of respiratory depression, profound sedation, coma, and death.
- Methadone Hydrochloride + Tranquilizers— CNS depressant effect increases risk of respiratory depression, profound sedation, coma, and death.
Moderate (1)
- Methadone Hydrochloride + Potentially Arrhythmogenic Agents— Pharmacodynamic interactions may occur. Monitor patients closely for cardiac conduction changes.