Drug interactions
Dextromoramide + Methadone
Severity: Major
Dextromoramide 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
Two opioid agonists taken together add to each other's sedative and respiratory depressant effects. Dextromoramide is a potent, short-acting opioid, so overdose and respiratory depression are a real concern, particularly in patients with limited opioid tolerance.
What this interaction means in plain words
Dextromoramide 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
Additive mu-opioid receptor agonism causing central nervous system and respiratory depression.
What to do
Avoid concurrent use where possible; if both are needed, reduce doses and titrate carefully. Monitor sedation and respiratory rate closely.
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 Dextromoramide with Methadone?
MediHelp rates the interaction as major. Dextromoramide 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. Two opioid agonists taken together add to each other's sedative and respiratory depressant effects. Dextromoramide is a potent, short-acting opioid, so overdose and respiratory depression are a real concern, particularly in patients with limited opioid tolerance.
How serious is the interaction between Dextromoramide 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 concurrent use where possible; if both are needed, reduce doses and titrate carefully. Monitor sedation and respiratory rate closely.
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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