Drug interactions
Methadone + Zotepine
Severity: Major
Methadone and Zotepine: 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
Zotepine is a sedating antipsychotic and can also prolong the QT interval. With methadone, additive sedation, respiratory depression and QT prolongation are possible; zotepine also lowers the seizure threshold.
What this interaction means in plain words
Methadone and Zotepine 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.
Why it happens
Additive CNS depression and additive QT prolongation.
What to do
Monitor sedation and respiratory status and obtain an ECG with electrolytes. Use the lowest effective doses.
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
Frequently asked questions
Can I take Methadone with Zotepine?
MediHelp rates the interaction as major. Methadone and Zotepine 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. Zotepine is a sedating antipsychotic and can also prolong the QT interval. With methadone, additive sedation, respiratory depression and QT prolongation are possible; zotepine also lowers the seizure threshold.
How serious is the interaction between Methadone and Zotepine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and respiratory status and obtain an ECG with electrolytes. Use the lowest effective doses.
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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