Drug interactions
Amiodarone + Methadone
Severity: Major
Amiodarone and Methadone: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both drugs prolong the QT interval, and amiodarone may also raise methadone exposure through CYP inhibition. The combination increases the risk of torsades de pointes and other ventricular arrhythmias.
What this interaction means in plain words
Amiodarone and Methadone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Amiodarone belongs to Cardiovascular; Methadone belongs to Musculoskeletal.
Why it happens
Additive QT prolongation via cardiac potassium channel blockade, plus possible inhibition of CYP-mediated methadone metabolism by amiodarone.
What to do
Avoid the combination where possible and consider an alternative antiarrhythmic or opioid. If it is unavoidable, obtain a baseline and follow-up ECG, correct potassium and magnesium, and monitor for arrhythmia.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Methadone
- Alvimopan + Methadone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Methadone Contraindicated
- Droperidol + Methadone Contraindicated
- Ibutilide + Methadone Contraindicated
- Isocarboxazid + Methadone Contraindicated
- Lefamulin + Methadone Contraindicated
Other interactions of Amiodarone
- Amiodarone + Amisulpride Contraindicated
- Amiodarone + Arsenic trioxide Contraindicated
- Amiodarone + Dofetilide Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Amiodarone + Droperidol Contraindicated
- Amiodarone + Eliglustat Contraindicated
Frequently asked questions
Can I take Amiodarone with Methadone?
MediHelp rates the interaction as major. Amiodarone and Methadone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Both drugs prolong the QT interval, and amiodarone may also raise methadone exposure through CYP inhibition. The combination increases the risk of torsades de pointes and other ventricular arrhythmias.
How serious is the interaction between Amiodarone and Methadone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination where possible and consider an alternative antiarrhythmic or opioid. If it is unavoidable, obtain a baseline and follow-up ECG, correct potassium and magnesium, and monitor for arrhythmia.
What other medicines interact with Methadone?
MediHelp also lists interactions of Methadone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Droperidol. The full list is on the Methadone page.
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