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methadone intravenous

Buprenorphine; Methadone; Morphine/Rifampin

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

When these two medicines are taken together, your body may process buprenorphine, methadone, and morphine more quickly.

What might happen:

Your blood levels of buprenorphine, methadone, or morphine may decrease and they may not work as well. You may experience drug withdrawal symptoms.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking these medicines together. If your medicine does not seem to be working as well, contact your healthcare professionals. If you experience nausea, vomiting, stomach pain, diarrhea, irritability, sleep disturbances, or other symptoms, contact your healthcare professionals. Your doctor may want to adjust the dose of your medicine.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

References:

1.McCance-Katz EF, Moody DE, Prathikanti S, Friedland G, Rainey PM. Rifampin, but not rifabutin, may produce opiate withdrawal in buprenorphine-maintained patients. Drug Alcohol Depend 2011 Nov 1; 118(2-3):326-34.
2.Raistrick D, Hay A, Wolff K. Methadone maintenance and tuberculosis treatment. BMJ 1996 Oct 12;313(7062):925-6.
3.Holmes VF. Rifampin-induced methadone withdrawal in AIDS. J Clin Psychopharmacol 1990 Dec;10(6):443-4.
4.Kreek MJ, Garfield JW, Gutjahr CL, Giusti LM. Rifampin-induced methadone withdrawal. N Engl J Med 1976 May 13;294(20):1104-6.
5.Bending MR, Skacel PO. Rifampicin and methadone withdrawal. Lancet 1977 Jun 4;1(8023):1211.
6.Garfield JW, Kreek MJ, Giusti L. Rifampin-methadone relationship. 1. The clinical effects of rifampin-methadone interaction. Am Rev Respir Dis 1975;3:926.
7.Kreek MJ, Garfield JW, Gutjahr CL, Bowen D, Field F, Rothschild M. Rifampin-methadone relationship. 2. Rifampin effects on plasma concentration, metabolism, and excretion of methadone. Am Rev Respir Dis 1975;3:926-927.
8.Fromm MF, Eckhardt K, Li S, Schanzle G, Hofmann U, Mikus G, Eichelbaum M. Loss of analgesic effect of morphine due to coadministration of rifampin. Pain 1997 Aug;72(1-2):261-7.

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