Drug interactions
Ivosidenib + Methadone
Severity: Major
Ivosidenib and Methadone: major interaction.
Last updated Sources: EMA SmPC
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
Both drugs can prolong the QT interval, raising the risk of torsades de pointes. Ivosidenib also induces CYP3A4, which may lower methadone levels and risk opioid withdrawal or loss of analgesia.
What this interaction means in plain words
Ivosidenib 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.
Ivosidenib belongs to Oncology; Methadone belongs to Musculoskeletal.
Why it happens
Additive QT prolongation plus CYP3A4 induction by ivosidenib increasing methadone clearance.
What to do
Monitor ECG and electrolytes and correct abnormalities. Watch for withdrawal or reduced methadone effect and adjust the dose accordingly, and reassess after ivosidenib is stopped.
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 Ivosidenib
- Alfuzosin + Ivosidenib Major
- Amiodarone + Ivosidenib Major
- Amisulpride + Ivosidenib Major
- Amitriptyline + Ivosidenib Major
- Amobarbital + Ivosidenib Major
- Anagrelide + Ivosidenib Major
Frequently asked questions
Can I take Ivosidenib with Methadone?
MediHelp rates the interaction as major. Ivosidenib 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. Both drugs can prolong the QT interval, raising the risk of torsades de pointes. Ivosidenib also induces CYP3A4, which may lower methadone levels and risk opioid withdrawal or loss of analgesia.
How serious is the interaction between Ivosidenib 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: Monitor ECG and electrolytes and correct abnormalities. Watch for withdrawal or reduced methadone effect and adjust the dose accordingly, and reassess after ivosidenib is stopped.
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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