Drug interactions
Methadone + Miconazole vaginal
Severity: Minor
Methadone and Miconazole vaginal: minor 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
Miconazole inhibits CYP3A4 and can be absorbed in small amounts from the vagina, which could modestly raise methadone concentrations. Clinically significant effects are likely uncommon, but excess opioid effects such as sedation or QT prolongation are theoretically possible, particularly with repeated or prolonged use.
What this interaction means in plain words
Methadone and Miconazole vaginal have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Why it happens
Inhibition of CYP3A4-mediated methadone metabolism by systemically absorbed miconazole.
What to do
No routine change is needed for a short vaginal course. Watch for increased sedation or respiratory depression, and consider ECG monitoring if the patient has other QT risk factors.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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
Frequently asked questions
Can I take Methadone with Miconazole vaginal?
MediHelp rates the interaction as minor. Methadone and Miconazole vaginal have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Miconazole inhibits CYP3A4 and can be absorbed in small amounts from the vagina, which could modestly raise methadone concentrations. Clinically significant effects are likely uncommon, but excess opioid effects such as sedation or QT prolongation are theoretically possible, particularly with repeated or prolonged use.
How serious is the interaction between Methadone and Miconazole vaginal?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No routine change is needed for a short vaginal course. Watch for increased sedation or respiratory depression, and consider ECG monitoring if the patient has other QT risk factors.
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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