Medication interactions are a serious concern that can greatly influence the effectiveness and risks associated with certain drugs. Methadone is no exception. Using medications not discussed with your provider can significantly decrease the effectiveness of treatment or cause serious side effects. Even something as inconspicuous as cough medicine or alcohol can be incredibly dangerous.
Always be completely honest with your healthcare providers about which medications you are taking, and don’t add anything else into your regimen without discussing it with them first. Mixing other medications with methadone can have severe effects.
Methadone and Other Medications
Many of the people seeking medication-assisted treatments (MAT) for addiction recovery also have co-occurring conditions that require medical treatment. While it isn’t always possible to cease taking medication for these issues, it’s still important to talk to a doctor about alternative options and to be aware of symptoms that could signal more serious problems.
Some medications that interact with methadone include:
- Benzodiazepines: Often used for sedation, seizure control and insomnia, benzodiazepines include diazepam (Valium), alprazolam (Xanax), lorazepam (Ativan) and clonazepam (Klonopin). Combining these with methadone can be especially dangerous due to their sedative effect on the central nervous system.
- Other opioids: Several opioids are prescribed for pain management, like hydrocodone, morphine and oxycodone. When combined with methadone, they can cause serious side effects like respiratory depression, hypotension, coma and profound sedation. Illegal opioids like heroin can cause similar effects.
- Selective serotonin reuptake inhibitors (SSRIs): SSRIs like sertraline (Zoloft) and fluoxetine (Prozac) are often used to treat depression and anxiety disorders. Some of these medications can cause serious irregular heart rhythms and other problems like dizziness, fainting and shortness of breath.
- HIV medications: If paired with methadone, many HIV medications — like AZT, didanosine, stavudine and darunavir — can affect concentrations, creating high levels of the drug or reducing methadone levels and its effectiveness.
You should also be aware of non-prescription drugs and substances that interact with methadone, including:
- Alcohol and marijuana: Both of these substances can deplete the methadone supply in the body, reducing its effects. They can also increase side effects associated with changes to the nervous system, like impaired thinking and motor skills, respiratory distress and low blood pressure.
- Herbs: The herb St. John’s Wort is often used to manage depression, but it can eliminate methadone in the body and increase withdrawal symptoms.
- Central Nervous System stimulants: Substances like caffeine and cocaine work by stimulating the nervous system, while methadone helps to relax it. This interaction can cause reduced methadone levels and effectiveness and irregular heart rhythms, which can be life-threatening.
Whether prescribed or not, always be wary of any drugs you take alongside methadone treatment and be completely honest with your healthcare provider about your usage.