Drug interactions
Methadone + Sotalol
Severity: Major
Methadone and Sotalol: 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
Both drugs prolong the QT interval, and sotalol is a class III antiarrhythmic with a recognized risk of torsades de pointes. Combined use can produce serious, potentially fatal ventricular arrhythmias.
What this interaction means in plain words
Methadone and Sotalol 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; Sotalol belongs to Cardiovascular.
Why it happens
Additive QT prolongation through cardiac potassium channel blockade.
What to do
Avoid the combination where possible and choose an alternative antiarrhythmic or opioid such as buprenorphine. If unavoidable, monitor the ECG closely and keep potassium and magnesium within normal limits.
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 Sotalol
- Arsenic trioxide + Sotalol Contraindicated
- Artemether / lumefantrine + Sotalol Contraindicated
- Disopyramide + Sotalol Contraindicated
- Dofetilide + Sotalol Contraindicated
- Dronedarone + Sotalol Contraindicated
- Droperidol + Sotalol Contraindicated
Frequently asked questions
Can I take Methadone with Sotalol?
MediHelp rates the interaction as major. Methadone and Sotalol 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. Both drugs prolong the QT interval, and sotalol is a class III antiarrhythmic with a recognized risk of torsades de pointes. Combined use can produce serious, potentially fatal ventricular arrhythmias.
How serious is the interaction between Methadone and Sotalol?
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 where possible and choose an alternative antiarrhythmic or opioid such as buprenorphine. If unavoidable, monitor the ECG closely and keep potassium and magnesium within normal limits.
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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