Drug interactions
Meperidine + Methadone
Severity: Major
Meperidine 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
Two opioids together cause additive respiratory and CNS depression. Meperidine also has a toxic metabolite and serotonergic activity, and cross-tolerance is incomplete, so overdose risk is increased.
What this interaction means in plain words
Meperidine 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.
Meperidine belongs to Musculoskeletal; Methadone belongs to Musculoskeletal.
Why it happens
Additive opioid receptor agonism causing CNS and respiratory depression.
What to do
Avoid unnecessary combined use, and monitor sedation and respiratory rate if both are required. Prefer a different opioid to meperidine in patients on methadone and have naloxone available.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Meperidine with Methadone?
MediHelp rates the interaction as major. Meperidine 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. Two opioids together cause additive respiratory and CNS depression. Meperidine also has a toxic metabolite and serotonergic activity, and cross-tolerance is incomplete, so overdose risk is increased.
How serious is the interaction between Meperidine 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 unnecessary combined use, and monitor sedation and respiratory rate if both are required. Prefer a different opioid to meperidine in patients on methadone and have naloxone available.
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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