Drug interactions
Lofexidine + Methadone
Severity: Major
Lofexidine 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
Lofexidine prolongs the QT interval and lowers blood pressure and heart rate, and methadone also prolongs QT. The combination increases arrhythmia risk and sedation, although the two are commonly used together in opioid withdrawal management.
What this interaction means in plain words
Lofexidine 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.
Lofexidine belongs to Central Nervous System; Methadone belongs to Musculoskeletal.
Why it happens
Additive QTc prolongation, with additive sedation and bradycardia or hypotension from alpha-2 agonism.
What to do
Perform ECG monitoring at baseline and during treatment, and monitor blood pressure and heart rate. Avoid in patients with long QT or bradycardia and correct electrolytes.
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 Lofexidine
- Adagrasib + Lofexidine Major
- Alfuzosin + Lofexidine Major
- Amiodarone + Lofexidine Major
- Amisulpride + Lofexidine Major
- Anagrelide + Lofexidine Major
- Apomorphine + Lofexidine Major
Frequently asked questions
Can I take Lofexidine with Methadone?
MediHelp rates the interaction as major. Lofexidine 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. Lofexidine prolongs the QT interval and lowers blood pressure and heart rate, and methadone also prolongs QT. The combination increases arrhythmia risk and sedation, although the two are commonly used together in opioid withdrawal management.
How serious is the interaction between Lofexidine 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: Perform ECG monitoring at baseline and during treatment, and monitor blood pressure and heart rate. Avoid in patients with long QT or bradycardia and correct electrolytes.
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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