Drug interactions
Methadone + Sunitinib
Severity: Major
Methadone and Sunitinib: major interaction.
Last updated Sources: Health Canada product monograph
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
Sunitinib is associated with QT prolongation and torsades de pointes, and methadone shares this risk. Combining them increases the likelihood of a clinically significant arrhythmia. Sunitinib is also a CYP3A4 substrate, so interacting drugs may alter exposure further.
What this interaction means in plain words
Methadone and Sunitinib 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; Sunitinib belongs to Oncology.
Why it happens
Additive QT prolongation by both drugs.
What to do
Perform a baseline ECG and repeat periodically during therapy, and correct electrolyte abnormalities. Consider alternatives to methadone or dose reduction if the QTc becomes markedly prolonged.
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 Sunitinib
- Adagrasib + Sunitinib Major
- Amiodarone + Sunitinib Major
- Amisulpride + Sunitinib Major
- Anagrelide + Sunitinib Major
- Apalutamide + Sunitinib Major
- Arsenic trioxide + Sunitinib Major
Frequently asked questions
Can I take Methadone with Sunitinib?
MediHelp rates the interaction as major. Methadone and Sunitinib 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. Sunitinib is associated with QT prolongation and torsades de pointes, and methadone shares this risk. Combining them increases the likelihood of a clinically significant arrhythmia. Sunitinib is also a CYP3A4 substrate, so interacting drugs may alter exposure further.
How serious is the interaction between Methadone and Sunitinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Perform a baseline ECG and repeat periodically during therapy, and correct electrolyte abnormalities. Consider alternatives to methadone or dose reduction if the QTc becomes markedly prolonged.
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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