Drug interactions
Methadone + Ranolazine
Severity: Moderate
Methadone and Ranolazine: moderate 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
Ranolazine prolongs the QT interval in a dose-related way and can inhibit CYP3A4 and CYP2D6, while methadone also prolongs QT. Together they may increase the risk of arrhythmia.
What this interaction means in plain words
Methadone and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Methadone belongs to Musculoskeletal; Ranolazine belongs to Cardiovascular.
Why it happens
Additive QT prolongation with possible CYP inhibition by ranolazine.
What to do
Obtain a baseline ECG and monitor the QTc and electrolytes, especially after dose changes. Use the lowest effective ranolazine dose.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Ranolazine
- Adagrasib + Ranolazine Contraindicated
- Amobarbital + Ranolazine Contraindicated
- Apalutamide + Ranolazine Contraindicated
- Butabarbital + Ranolazine Contraindicated
- Carbamazepine + Ranolazine Contraindicated
- Clarithromycin + Ranolazine Contraindicated
Frequently asked questions
Can I take Methadone with Ranolazine?
MediHelp rates the interaction as moderate. Methadone and Ranolazine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Ranolazine prolongs the QT interval in a dose-related way and can inhibit CYP3A4 and CYP2D6, while methadone also prolongs QT. Together they may increase the risk of arrhythmia.
How serious is the interaction between Methadone and Ranolazine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline ECG and monitor the QTc and electrolytes, especially after dose changes. Use the lowest effective ranolazine dose.
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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