Drug interactions
Methadone + Remimazolam
Severity: Major
Methadone and Remimazolam: 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
Combining an opioid with a benzodiazepine sedative can cause profound sedation, respiratory depression, coma and death. The risk is greater in patients with respiratory disease or on high opioid doses.
What this interaction means in plain words
Methadone and Remimazolam 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; Remimazolam belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression from opioid and GABA-A receptor agonist effects.
What to do
Titrate remimazolam carefully using lower doses, and continuously monitor oxygenation, respiration and vital signs through recovery. Ensure resuscitation equipment is available.
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 Remimazolam
Frequently asked questions
Can I take Methadone with Remimazolam?
MediHelp rates the interaction as major. Methadone and Remimazolam 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. Combining an opioid with a benzodiazepine sedative can cause profound sedation, respiratory depression, coma and death. The risk is greater in patients with respiratory disease or on high opioid doses.
How serious is the interaction between Methadone and Remimazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate remimazolam carefully using lower doses, and continuously monitor oxygenation, respiration and vital signs through recovery. Ensure resuscitation equipment is available.
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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