Drug interactions
Hydrocodone + Methadone
Severity: Major
Hydrocodone and Methadone: major 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
Combining two opioids causes additive sedation and respiratory depression that can progress to coma or death. Methadone's prolonged and unpredictable elimination adds to the danger.
What this interaction means in plain words
Hydrocodone 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.
Hydrocodone belongs to Musculoskeletal; Methadone belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism with pharmacodynamic CNS and respiratory depression.
What to do
Avoid unless other options are inadequate; use minimal doses and durations and monitor for sedation and respiratory depression. Offer naloxone 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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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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Hydrocodone with Methadone?
MediHelp rates the interaction as major. Hydrocodone 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. Combining two opioids causes additive sedation and respiratory depression that can progress to coma or death. Methadone's prolonged and unpredictable elimination adds to the danger.
How serious is the interaction between Hydrocodone 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 unless other options are inadequate; use minimal doses and durations and monitor for sedation and respiratory depression. Offer naloxone 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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