Drug interactions
Methadone + Nilotinib
Severity: Major
Methadone and Nilotinib: 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
Both drugs prolong the QT interval, and nilotinib can also inhibit methadone metabolism, raising its levels. The combination increases the risk of torsades de pointes and other serious ventricular arrhythmias.
What this interaction means in plain words
Methadone and Nilotinib 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; Nilotinib belongs to Oncology.
Why it happens
Additive QT prolongation, plus CYP3A4 inhibition by nilotinib that increases methadone exposure.
What to do
Avoid the combination where possible; if it is necessary, obtain a baseline ECG and monitor the QTc and electrolytes (potassium, magnesium) regularly. Correct electrolyte abnormalities and consider an alternative opioid or oncology agent if QTc lengthens.
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 Nilotinib
- Amiodarone + Nilotinib Contraindicated
- Arsenic trioxide + Nilotinib Contraindicated
- Disopyramide + Nilotinib Contraindicated
- Dofetilide + Nilotinib Contraindicated
- Dronedarone + Nilotinib Contraindicated
- Droperidol + Nilotinib Contraindicated
Frequently asked questions
Can I take Methadone with Nilotinib?
MediHelp rates the interaction as major. Methadone and Nilotinib 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 prolong the QT interval, and nilotinib can also inhibit methadone metabolism, raising its levels. The combination increases the risk of torsades de pointes and other serious ventricular arrhythmias.
How serious is the interaction between Methadone and Nilotinib?
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 where possible; if it is necessary, obtain a baseline ECG and monitor the QTc and electrolytes (potassium, magnesium) regularly. Correct electrolyte abnormalities and consider an alternative opioid or oncology agent if QTc lengthens.
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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