Drug interactions
Methadone + Sufentanil
Severity: Major
Methadone and Sufentanil: 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 excessive sedation and respiratory depression. Sufentanil is very potent, and methadone has a long half-life, so effects can persist.
What this interaction means in plain words
Methadone and Sufentanil 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; Sufentanil belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor-mediated CNS and respiratory depression.
What to do
Reduce the sufentanil dose where possible and monitor respiratory rate, oxygen saturation and sedation continuously in perioperative or procedural settings. Have naloxone available.
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 Sufentanil
- Alprazolam + Sufentanil Major
- Amitriptyline + Sufentanil Major
- Amobarbital + Sufentanil Major
- Aripiprazole + Sufentanil Major
- Asenapine + Sufentanil Major
- Baclofen + Sufentanil Major
Frequently asked questions
Can I take Methadone with Sufentanil?
MediHelp rates the interaction as major. Methadone and Sufentanil 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 excessive sedation and respiratory depression. Sufentanil is very potent, and methadone has a long half-life, so effects can persist.
How serious is the interaction between Methadone and Sufentanil?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the sufentanil dose where possible and monitor respiratory rate, oxygen saturation and sedation continuously in perioperative or procedural settings. Have naloxone available.
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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