Drug interactions
Cenobamate + Methadone
Severity: Moderate
Cenobamate and Methadone: moderate 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
Cenobamate may lower methadone concentrations, which can lead to reduced analgesia or opioid withdrawal symptoms in patients on maintenance therapy. Both drugs also cause CNS depression. If cenobamate is stopped, methadone levels may rise again.
What this interaction means in plain words
Cenobamate and Methadone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Cenobamate belongs to Central Nervous System; Methadone belongs to Musculoskeletal.
Why it happens
Cenobamate induces CYP3A4 (and CYP2B6), increasing methadone metabolism and lowering its exposure.
What to do
Monitor for withdrawal or loss of effect after starting cenobamate and increase methadone dose as clinically needed. Reassess and reduce the dose if cenobamate is discontinued.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Cenobamate
Frequently asked questions
Can I take Cenobamate with Methadone?
MediHelp rates the interaction as moderate. Cenobamate and Methadone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Cenobamate may lower methadone concentrations, which can lead to reduced analgesia or opioid withdrawal symptoms in patients on maintenance therapy. Both drugs also cause CNS depression. If cenobamate is stopped, methadone levels may rise again.
How serious is the interaction between Cenobamate and Methadone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for withdrawal or loss of effect after starting cenobamate and increase methadone dose as clinically needed. Reassess and reduce the dose if cenobamate is discontinued.
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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