Drug interactions
Methadone + Sevoflurane
Severity: Moderate
Methadone and Sevoflurane: 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
Sevoflurane can prolong the QT interval, and methadone has the same effect. Under anesthesia, combined exposure may increase the risk of ventricular arrhythmias such as torsades de pointes, and opioid and anesthetic effects on sedation and respiration are also additive.
What this interaction means in plain words
Methadone and Sevoflurane 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; Sevoflurane belongs to Central Nervous System.
Why it happens
Additive QT prolongation and additive CNS and respiratory depression.
What to do
Review the preoperative ECG QTc and correct potassium and magnesium before anesthesia. Monitor the ECG continuously during and after surgery and avoid other QT-prolonging drugs such as ondansetron where possible.
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 Sevoflurane
Frequently asked questions
Can I take Methadone with Sevoflurane?
MediHelp rates the interaction as moderate. Methadone and Sevoflurane 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. Sevoflurane can prolong the QT interval, and methadone has the same effect. Under anesthesia, combined exposure may increase the risk of ventricular arrhythmias such as torsades de pointes, and opioid and anesthetic effects on sedation and respiration are also additive.
How serious is the interaction between Methadone and Sevoflurane?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Review the preoperative ECG QTc and correct potassium and magnesium before anesthesia. Monitor the ECG continuously during and after surgery and avoid other QT-prolonging drugs such as ondansetron where possible.
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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