Drug interactions
Azelastine + Methadone
Severity: Major
Azelastine 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
Azelastine may intensify methadone-related sedation and respiratory depression. Methadone has a long, variable half-life, so excess CNS depression can emerge and persist.
What this interaction means in plain words
Azelastine 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.
Azelastine belongs to Respiratory; Methadone belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression from H1-antagonist sedation and mu-opioid agonism.
What to do
Monitor sedation and respiratory status, particularly at initiation and dose changes. Avoid other CNS depressants and consider a non-sedating antihistamine alternative.
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 Azelastine
- Azelastine + Calcium / magnesium / potassium / sodium oxybates Major
- Azelastine + Sodium oxybate Major
- Alfentanil + Azelastine Moderate
- Alprazolam + Azelastine Moderate
- Amitriptyline + Azelastine Moderate
- Amobarbital + Azelastine Moderate
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
Frequently asked questions
Can I take Azelastine with Methadone?
MediHelp rates the interaction as major. Azelastine 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. Azelastine may intensify methadone-related sedation and respiratory depression. Methadone has a long, variable half-life, so excess CNS depression can emerge and persist.
How serious is the interaction between Azelastine 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: Monitor sedation and respiratory status, particularly at initiation and dose changes. Avoid other CNS depressants and consider a non-sedating antihistamine alternative.
What other medicines interact with Azelastine?
MediHelp also lists interactions of Azelastine with, for example, Calcium / magnesium / potassium / sodium oxybates, Sodium oxybate, Alfentanil. The full list is on the Azelastine page.
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