Drug interactions
Methadone + Trazodone
Severity: Moderate
Methadone and Trazodone: 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 drugs can prolong the QT interval, so the combination increases the risk of torsades de pointes. They also add to sedation, and trazodone has weak serotonergic activity that may contribute to serotonin toxicity with opioids.
What this interaction means in plain words
Methadone and Trazodone 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; Trazodone belongs to Central Nervous System.
Why it happens
Additive QT prolongation and CNS depression; trazodone is also metabolised by CYP3A4, and serotonergic effects are additive.
What to do
Obtain a baseline and follow-up ECG, check electrolytes, and use the lowest effective trazodone dose. Warn the patient about daytime sedation and monitor for signs of serotonin toxicity.
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 Trazodone
- Arsenic trioxide + Trazodone Contraindicated
- Ibutilide + Trazodone Contraindicated
- Isocarboxazid + Trazodone Contraindicated
- Levoketoconazole + Trazodone Contraindicated
- Methylene blue + Trazodone Contraindicated
- Phenelzine + Trazodone Contraindicated
Frequently asked questions
Can I take Methadone with Trazodone?
MediHelp rates the interaction as moderate. Methadone and Trazodone 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 drugs can prolong the QT interval, so the combination increases the risk of torsades de pointes. They also add to sedation, and trazodone has weak serotonergic activity that may contribute to serotonin toxicity with opioids.
How serious is the interaction between Methadone and Trazodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Obtain a baseline and follow-up ECG, check electrolytes, and use the lowest effective trazodone dose. Warn the patient about daytime sedation and monitor for signs of serotonin toxicity.
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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