Drug Interactions

[candy]

Hey all,
I just thought I might post on drug interactions with Methadone.
With so many of us on Methadone, I thought it was important to post, especially since many clinics don't have the info to share.

Drugs that cause an increase in Methadone metabolization:

Carbamazepin(Tegretol), Used for seizures
Phenytoin(Dilantin), Used for seizures
Neverapine(Virammune), Used to treat HIV
Rifampin, Used to treat TB( Tuberculosis
Ritonavir(Norvir), Less of an effect, Used to treat HIV
St. John's Wort

Drugs that cause a decrease in Methadone metabolism:

Amitryptline(Elavil) Used for Depression
Cimetidine(Tagamet), Decreases acid production in the GI Tract
Fluvoxamine(Luvox), Improves Obsessive Compulsive Disorder
Ketoconazole(Nizoral), Used to treat fungul infections

Drugs that block Methadone and cause WITHDRAWALS:

Pentazocine(Talwin), Opiate, used to treat moderate to severe pain
Naltrexone(Revia)
Tramadol(Ultram), Analgesic used to treat pain.
Stadol, Opioid Analgesic, used to treat moderqte to severe pain

Some drugs may initially interact with Methadone to cause sedation, but then cause the opposite effect to occur and cause withdrawal:

Benzodiazepines: Xanax, Valium, Ativan
Alcohol
Barbituates

Be careful with Demerol as well. It has been noted that Demerol can lead to seizures when given to someone on Methadone. Demerol lowers the seizure threshold.


Also noted: HIV medications as Virammune(listed above) have been noted to cause an increase or decrease in Methadone metabolism. Check with your doctor.

I hope this helps. If anyone has anything to add to this, please do.

[mkchll]

I take Methadone daily and I've never had a problem taking Tramadol (Ultram). Does anyone have problems with Ultram that's on Methadone? I once took 8mg's of Suboxone (Buprenorphine) and that sent me into instant Methadone withdrawals. It only lasted a few hour but it was the worst few hours of my life.

[mmnyc9]

Elavil is real popular among some people as a (booster?) and clonadine, cheap but they seem to like it.
I have heard Talwin produces a LCD like effect, I dont know if this is true, but this is the one that is the most Taboo its printed right on the clinic card. Does anyone know what Talwin and Meth really do?

[candy]

Like any medication, Methadone can interact with other drugs. In saying this, it is possible that different people will have different effects. There may be other drugs that interact with Methadone. The interaction may be subtle and the user may not notice the effect or mistake it for something else or the interaction may be quite extreme, as it is with withdrawals.

I myself have taken Benzodiazepines with Methadone and did have the sedative effect, but did not have any withdrawals. It may vary from person to person.

My suggestion to anyone on Methadone or any other drugs, whether illicit or not; Be cautious! A test dose perhaps to see what, if any reaction that may occur.

Liver metabolism is an important factor in the interaction of drugs. Like with elderly who metabolize drugs much slower, this may be an issue in anyone who has liver disease.

[astro]

Where can I find more information about the effect of Methadone and Demerol. I have looked Everywhere. not everywhere, but in my pdr and on the internet for the past 2.5 hours. i dont understand, is there an increase in sedation and then the risk of seizure or is it no effect and then seizure risk, or withdrawal reaction and then seizure (the worst, i assume)?

[sylis]

Here is a website with a pretty comprehensive list of methadone interactions.

http://www.atforum.com/mdi_booklet.shtml

[Sinderella]

First off the reason Talwin Nx is listed as "taboo" with methadone is because it contains Pentazocine and Naloxone which as most of us here at opiodphiles know isnt a good combo with other opiates especially Methadone..As Naloxone is an antagonist.. I do remember though back years ago before I ever really took drugs I tore the ligaments and tendons in my shoulder and the ortho doc gave me talwin..When I did take it I had some hallucinations.I remember seeing spiders on the ceiling and not just any old spiders these were 2-3ft across..But I guess I can say it did take the pain away pretty well...........


Another reaction thats not listed on here is Depakote and methadone..I have only found a couple places on the internet that list depakote as causing increased methadone metabolism but I can tell you from experience that it does..Atleast it has for me...When I first started taking it again back a year and a half ago I ended up having to go from 70mg where I was actually comfortable to the 120mg I am at now and still having withdrawal symptoms in the evenings and severely in the mornings.(clinic doctor/medical director is an idiot so no chance of increase at this time despite my mbls being under 140) Btw Depakote was originally a anti seizure drug that is now often used for bipolar disorder as well as prevention of migraine headaches..I use the med for both the last two things I listed..

Also alot of women dont realize that menopause can have an affect on your dose..Women on methadone often need increases in doses during this time..

Yall take care....
**~*~**SiNdErElLa**~*~**

[Mcdom]

never knew that info about menoause and doseage ..... good to know!