Drug interactions
Methadone + Tacrolimus
Severity: Moderate
Methadone and Tacrolimus: 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
Both agents can prolong the QT interval, so concurrent use may raise the risk of torsades de pointes, especially with electrolyte disturbances such as low magnesium that tacrolimus can cause. Methadone metabolism via CYP3A4 may also be influenced by tacrolimus levels.
What this interaction means in plain words
Methadone and Tacrolimus 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; Tacrolimus belongs to Miscellaneous.
Why it happens
Additive QT prolongation, with tacrolimus-related hypomagnesemia and hypokalemia as contributing factors.
What to do
Check a baseline ECG and monitor it periodically, together with serum magnesium and potassium. Replace electrolytes as needed and monitor tacrolimus trough levels.
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 Tacrolimus
- Adenovirus types 4 and 7 live + Tacrolimus Contraindicated
- Bcg vaccine live + Tacrolimus Contraindicated
- Cidofovir + Tacrolimus Contraindicated
- Cyclosporin + Tacrolimus Contraindicated
- Influenza virus vaccine quadrivalent intranasal + Tacrolimus Contraindicated
- Measles mumps and rubella vaccine live + Tacrolimus Contraindicated
Frequently asked questions
Can I take Methadone with Tacrolimus?
MediHelp rates the interaction as moderate. Methadone and Tacrolimus 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. Both agents can prolong the QT interval, so concurrent use may raise the risk of torsades de pointes, especially with electrolyte disturbances such as low magnesium that tacrolimus can cause. Methadone metabolism via CYP3A4 may also be influenced by tacrolimus levels.
How serious is the interaction between Methadone and Tacrolimus?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Check a baseline ECG and monitor it periodically, together with serum magnesium and potassium. Replace electrolytes as needed and monitor tacrolimus trough levels.
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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