Methadone Drug-Drug Interactions
Meds that increase methadone metabolism/decrease methadone effect (INCREASED RISK FOR OPIOID WITHDRAWAL):
 • Phenytoin, Phenobarbital, Carbamazepine, Dexamethasone, Rifampicin/rifabutin, NNRTIs (efavirenz, nevirapine), Ritonavir , Vitamin C (ascorbic acid), St John’s Wort 
Medications that decrease methadone metabolism/increase effect (INCREASED SEDATION/CNS DEPRESSION):
 • SSRI Antidepressants, Fluoroquinolones (increased sedation and prolonged Qtc time), Diltiazem, Cimetidine, Risperidone, Dextromethorphan, Chlorpromazine, Grapefruit juice, Indinavir, Azoles

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