Drug interactions
Methadone + Safinamide
Severity: Contraindicated
Methadone and Safinamide: contraindicated 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
Safinamide is a MAO-B inhibitor, and labeling contraindicates use with opioids such as methadone due to reported serotonin syndrome. Methadone inhibits serotonin reuptake to some extent, which increases the concern.
What this interaction means in plain words
Methadone and Safinamide are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Methadone belongs to Musculoskeletal; Safinamide belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from MAO inhibition and methadone's serotonin reuptake inhibition.
What to do
Avoid the combination; use an alternative to one of the drugs. If serotonin toxicity appears, stop both and give supportive care.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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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 Safinamide
- Amitriptyline + Safinamide Contraindicated
- Amoxapine + Safinamide Contraindicated
- Amphetamine polistirex + Safinamide Contraindicated
- Clomipramine + Safinamide Contraindicated
- Cyclobenzaprine + Safinamide Contraindicated
- Desipramine + Safinamide Contraindicated
Frequently asked questions
Can I take Methadone with Safinamide?
MediHelp rates the interaction as contraindicated. Methadone and Safinamide are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Safinamide is a MAO-B inhibitor, and labeling contraindicates use with opioids such as methadone due to reported serotonin syndrome. Methadone inhibits serotonin reuptake to some extent, which increases the concern.
How serious is the interaction between Methadone and Safinamide?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination; use an alternative to one of the drugs. If serotonin toxicity appears, stop both and give supportive care.
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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