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Drug interactions

Ibutilide + Methadone

Severity: Contraindicated

Ibutilide and Methadone: contraindicated 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

Ibutilide markedly prolongs repolarization and causes torsades de pointes; adding methadone, which also prolongs QT, further raises this risk. The arrhythmia can be rapid and fatal.

What this interaction means in plain words

Ibutilide and Methadone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Ibutilide belongs to Cardiovascular; Methadone belongs to Musculoskeletal.

Evidence level: Moderate

Why it happens

Additive pharmacodynamic QT prolongation via potassium channel (hERG) blockade.

What to do

Do not give together; use an alternative rhythm-control strategy such as electrical cardioversion if appropriate. If methadone cannot be withheld, ensure continuous ECG monitoring and correct electrolytes, accepting substantial risk.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Ibutilide with Methadone?

MediHelp rates the interaction as contraindicated. Ibutilide and Methadone are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Ibutilide markedly prolongs repolarization and causes torsades de pointes; adding methadone, which also prolongs QT, further raises this risk. The arrhythmia can be rapid and fatal.

How serious is the interaction between Ibutilide and Methadone?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not give together; use an alternative rhythm-control strategy such as electrical cardioversion if appropriate. If methadone cannot be withheld, ensure continuous ECG monitoring and correct electrolytes, accepting substantial risk.

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.

Full monographs, dosing and an interaction checker in the MediHelp app

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