Drug interactions
Methadone + Nabilone
Severity: Major
Methadone and Nabilone: major interaction.
Last updated Sources: UK 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
Cannabinoids and opioids both cause sedation, and together they may deepen drowsiness and impair psychomotor performance. Methadone also carries a risk of respiratory depression, which could be worsened by additional CNS depressants.
What this interaction means in plain words
Methadone and Nabilone 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.
Methadone belongs to Musculoskeletal; Nabilone belongs to Gastrointestinal Tract.
Why it happens
Additive CNS and respiratory depressant effects of a cannabinoid and an opioid.
What to do
Avoid the combination if possible; if used, give the lowest effective doses and monitor sedation and respiratory rate, especially during initiation and dose changes. Counsel patients and caregivers about warning signs of oversedation.
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
- Nabilone 0.25mg Capsule - SmPC sections 4.3/4.5 (class statement: opioids; "Barbiturates, benzodiazepines, lithium, opioids, buspirone, muscle relaxants,") — electronic medicines compendium (UK SmPC)
Other interactions of Nabilone
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 Nabilone?
MediHelp rates the interaction as major. Methadone and Nabilone 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. Cannabinoids and opioids both cause sedation, and together they may deepen drowsiness and impair psychomotor performance. Methadone also carries a risk of respiratory depression, which could be worsened by additional CNS depressants.
How serious is the interaction between Methadone and Nabilone?
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 the combination if possible; if used, give the lowest effective doses and monitor sedation and respiratory rate, especially during initiation and dose changes. Counsel patients and caregivers about warning signs of oversedation.
What other medicines interact with Nabilone?
MediHelp also lists interactions of Nabilone with, for example, Alfentanil, Amobarbital, Belladonna and opium. The full list is on the Nabilone page.
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