Drug interactions
Butalbital + Methadone
Severity: Major
Butalbital and Methadone: major interaction.
Last updated Sources: US FDA label
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
Butalbital is a barbiturate that can induce methadone metabolism, potentially causing withdrawal or loss of analgesia. It also adds to sedation and respiratory depression with opioids.
What this interaction means in plain words
Butalbital 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.
Why it happens
CYP3A4 induction increasing methadone clearance, with additive CNS depression.
What to do
Avoid regular use together where possible. Monitor for withdrawal and for sedation, and adjust methadone dose if the combination continues.
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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References
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 Butalbital with Methadone?
MediHelp rates the interaction as major. Butalbital 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. Butalbital is a barbiturate that can induce methadone metabolism, potentially causing withdrawal or loss of analgesia. It also adds to sedation and respiratory depression with opioids.
How serious is the interaction between Butalbital 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 regular use together where possible. Monitor for withdrawal and for sedation, and adjust methadone dose if the combination continues.
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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