Drug interactions
Methadone + Rilpivirine
Severity: Moderate
Methadone and Rilpivirine: 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
Rilpivirine modestly lowers methadone exposure without usually causing withdrawal, but methadone and higher-dose rilpivirine both have QT-prolonging potential. Together they may add to arrhythmia risk in susceptible patients.
What this interaction means in plain words
Methadone and Rilpivirine 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; Rilpivirine belongs to Anti Virals.
Why it happens
Small pharmacokinetic reduction in methadone exposure plus additive QT prolongation.
What to do
No empiric dose change is needed, but monitor for withdrawal and adjust methadone if required. Consider ECG monitoring in patients with other QT risk factors.
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 Rilpivirine
- Carbamazepine + Rilpivirine Contraindicated
- Dexamethasone + Rilpivirine Contraindicated
- Dexlansoprazole + Rilpivirine Contraindicated
- Efavirenz + Rilpivirine Contraindicated
- Eslicarbazepine + Rilpivirine Contraindicated
- Esomeprazole + Rilpivirine Contraindicated
Frequently asked questions
Can I take Methadone with Rilpivirine?
MediHelp rates the interaction as moderate. Methadone and Rilpivirine 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. Rilpivirine modestly lowers methadone exposure without usually causing withdrawal, but methadone and higher-dose rilpivirine both have QT-prolonging potential. Together they may add to arrhythmia risk in susceptible patients.
How serious is the interaction between Methadone and Rilpivirine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No empiric dose change is needed, but monitor for withdrawal and adjust methadone if required. Consider ECG monitoring in patients with other QT risk factors.
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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