Drug interactions
Methadone + Selegiline transdermal
Severity: Major
Methadone and Selegiline transdermal: 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
Opioids combined with MAO inhibitors have caused serious reactions including serotonin-like toxicity, hypotension, hyperthermia and CNS depression. Transdermal selegiline at antidepressant doses carries MAOI-class warnings for opioid use, and methadone has serotonergic activity.
What this interaction means in plain words
Methadone and Selegiline transdermal 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.
Why it happens
MAO inhibition combined with the serotonergic and CNS depressant activity of methadone; the exact mechanism is not fully established.
What to do
Avoid the combination; use an opioid with less serotonergic activity if analgesia is required. Monitor for agitation, hyperthermia, rigidity and blood pressure changes if exposure cannot be avoided.
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
Frequently asked questions
Can I take Methadone with Selegiline transdermal?
MediHelp rates the interaction as major. Methadone and Selegiline transdermal 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. Opioids combined with MAO inhibitors have caused serious reactions including serotonin-like toxicity, hypotension, hyperthermia and CNS depression. Transdermal selegiline at antidepressant doses carries MAOI-class warnings for opioid use, and methadone has serotonergic activity.
How serious is the interaction between Methadone and Selegiline transdermal?
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; use an opioid with less serotonergic activity if analgesia is required. Monitor for agitation, hyperthermia, rigidity and blood pressure changes if exposure cannot be avoided.
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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