Drug interactions
Clorazepate + Methadone
Severity: Major
Clorazepate 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
Opioids combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death, as stated in boxed warnings. Clorazepate is converted to a long-acting active metabolite, so effects may persist.
What this interaction means in plain words
Clorazepate 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.
Clorazepate belongs to Central Nervous System; Methadone belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid and GABA-A receptor effects.
What to do
Avoid the combination unless no alternative exists; use the lowest doses and shortest duration. Monitor sedation and breathing and counsel the patient and caregivers.
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
Other interactions of Clorazepate
- Calcium / magnesium / potassium / sodium oxybates + Clorazepate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
- Alfentanil + Clorazepate Major
- Alprazolam + Clorazepate Major
- Amobarbital + Clorazepate Major
- Belladonna and opium + Clorazepate Major
Frequently asked questions
Can I take Clorazepate with Methadone?
MediHelp rates the interaction as major. Clorazepate 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. Opioids combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death, as stated in boxed warnings. Clorazepate is converted to a long-acting active metabolite, so effects may persist.
How serious is the interaction between Clorazepate 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 unless no alternative exists; use the lowest doses and shortest duration. Monitor sedation and breathing and counsel the patient and caregivers.
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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