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Drug interactions

Methadone + Sufentanil sl

Severity: Major

Methadone and Sufentanil sl: 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

Combining two opioids increases the risk of profound sedation, respiratory depression, hypotension, coma and death. Sublingual sufentanil is a potent opioid and the combination calls for caution in opioid-tolerant patients.

What this interaction means in plain words

Methadone and Sufentanil sl 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.

Evidence level: High

Why it happens

Additive opioid receptor-mediated CNS and respiratory depression.

What to do

Reserve the combination for patients with inadequate alternatives, using the lowest effective doses and shortest duration. Monitor closely for sedation and respiratory depression.

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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Methadone with Sufentanil sl?

MediHelp rates the interaction as major. Methadone and Sufentanil sl 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. Combining two opioids increases the risk of profound sedation, respiratory depression, hypotension, coma and death. Sublingual sufentanil is a potent opioid and the combination calls for caution in opioid-tolerant patients.

How serious is the interaction between Methadone and Sufentanil sl?

MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve the combination for patients with inadequate alternatives, using the lowest effective doses and shortest duration. Monitor closely for sedation and respiratory depression.

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.

Full monographs, dosing and an interaction checker in the MediHelp app

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