Drug interactions
Dronedarone + Methadone
Severity: Major
Dronedarone 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
Dronedarone prolongs the QT interval and inhibits CYP3A4 and CYP2D6, which may raise methadone levels. Together these effects increase the risk of torsades de pointes and ventricular arrhythmia.
What this interaction means in plain words
Dronedarone 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.
Dronedarone belongs to Cardiovascular; Methadone belongs to Musculoskeletal.
Why it happens
Additive QT prolongation plus inhibition of CYP3A4 and CYP2D6-mediated methadone metabolism.
What to do
Avoid the combination when possible and choose an alternative antiarrhythmic. If unavoidable, obtain a baseline and follow-up ECG, correct potassium and magnesium, and consider a methadone dose reduction.
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 Dronedarone
- Adagrasib + Dronedarone Contraindicated
- Amiodarone + Dronedarone Contraindicated
- Arsenic trioxide + Dronedarone Contraindicated
- Artemether / lumefantrine + Dronedarone Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Azithromycin + Dronedarone Contraindicated
Frequently asked questions
Can I take Dronedarone with Methadone?
MediHelp rates the interaction as major. Dronedarone 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. Dronedarone prolongs the QT interval and inhibits CYP3A4 and CYP2D6, which may raise methadone levels. Together these effects increase the risk of torsades de pointes and ventricular arrhythmia.
How serious is the interaction between Dronedarone 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 when possible and choose an alternative antiarrhythmic. If unavoidable, obtain a baseline and follow-up ECG, correct potassium and magnesium, and consider a methadone dose reduction.
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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