Methadone and Alcohol / Food Interactions

There are 2 alcohol/food/lifestyle interactions with methadone which include:

GENERALLY AVOID: The central nervous system-depressant effects of opioid analgesics and ethanol may be additive. The combination of these agents may result in additive CNS-depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, respiratory depression, hypotension, profound sedation, and coma can occur. Death has been reported in overdosage.

MANAGEMENT: The concomitant use of opioid analgesics and ethanol should be avoided.

GENERALLY AVOID: Coadministration with grapefruit juice may increase the plasma concentrations of methadone. The proposed mechanism is inhibition of CYP450 3A4-mediated first-pass metabolism in the gut wall by certain compounds present in grapefruits. In 8 study subjects stabilized on methadone maintenance treatment, ingestion of regular strength grapefruit juice (200 mL one-half hour before and 200 mL simultaneously with the daily methadone dose) for five days resulted in an approximately 17% mean increase in methadone peak plasma concentration (Cmax) and systemic exposure (AUC) and a 14% mean decrease in apparent clearance for both the R(+) and S(-) enantiomers. Grapefruit juice did not affect the time to peak level (Tmax), terminal half-life, or apparent volume of distribution of methadone. No signs or symptoms of methadone toxicity or changes in intensity of withdrawal symptoms were reported in the study.

MANAGEMENT: Given the interindividual variability in the pharmacokinetics of methadone, a more significant interaction with grapefruit juice in certain patients cannot be ruled out. Patients treated with methadone should preferably avoid or limit the consumption of grapefruit juice, particularly during the induction of maintenance treatment.

You should also know about...

methadone drug Interactions

There are 880 drug interactions with methadone

methadone disease Interactions

There are 16 disease interactions with methadone which include:

Impaired Gi Motility Infectious Diarrhea Liver Disease Prematurity Renal Dysfunction Acute Alcohol Intoxication Drug Dependence Hypotension

Intracranial Pressure Respiratory Depression Adrenal Insufficiency Biliary Spasm Hypothyroidism Seizure Disorders Urinary Retention Arrhythmias

See also...

• Methadone Side Effects
• Methadone Consumer Information

• Drug Interactions Checker

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