Drug interactions
Methadone + Pregabalin
Severity: Major
Methadone and Pregabalin: major interaction.
Last updated Sources: US FDA label
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
Pregabalin adds to the sedative and respiratory depressant effects of methadone. The combination can lead to profound sedation and potentially fatal respiratory depression, particularly in at-risk patients.
What this interaction means in plain words
Methadone and Pregabalin 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; Pregabalin belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression through pharmacodynamic synergism.
What to do
Use the lowest effective doses of both drugs and titrate cautiously. Monitor for sedation and respiratory depression, especially after dose changes and in patients with renal impairment or lung disease.
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 Pregabalin
Frequently asked questions
Can I take Methadone with Pregabalin?
MediHelp rates the interaction as major. Methadone and Pregabalin 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. Pregabalin adds to the sedative and respiratory depressant effects of methadone. The combination can lead to profound sedation and potentially fatal respiratory depression, particularly in at-risk patients.
How serious is the interaction between Methadone and Pregabalin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses of both drugs and titrate cautiously. Monitor for sedation and respiratory depression, especially after dose changes and in patients with renal impairment or lung disease.
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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