Drug interactions
Methadone + Rasagiline
Severity: Major
Methadone and Rasagiline: major interaction.
Last updated Sources: Health Canada product monograph
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
MAO inhibitors given with opioids have caused severe reactions including serotonin toxicity, hypotension, hyperthermia and CNS depression. Methadone has serotonergic activity, and rasagiline labeling advises caution with opioids.
What this interaction means in plain words
Methadone and Rasagiline 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; Rasagiline belongs to Central Nervous System.
Why it happens
Possible serotonergic potentiation and additive CNS effects with MAO inhibition; not fully established.
What to do
Avoid the combination where possible. If both are required, monitor for serotonin syndrome, blood pressure and sedation.
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 Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Methadone with Rasagiline?
MediHelp rates the interaction as major. Methadone and Rasagiline 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. MAO inhibitors given with opioids have caused severe reactions including serotonin toxicity, hypotension, hyperthermia and CNS depression. Methadone has serotonergic activity, and rasagiline labeling advises caution with opioids.
How serious is the interaction between Methadone and Rasagiline?
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 both are required, monitor for serotonin syndrome, blood pressure and sedation.
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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