Methadone Tablets and Miconazole oral buccal

In the database of official manuals used in the service creation an interaction registered by statistical results of studies was found, which can either lead to negative consequences for the patient health or strengthen a mutual positive effect. A doctor should be consulted to address the issue of joint drug administration.

Miconazole may increase the blood levels and effects of methadone. You may need a dose adjustment or more frequent monitoring by your doctor to safely use both medications. Let your doctor know if you experience excessive drowsiness, nausea, weakness, or difficult or shallow breathing while taking these medications, as they may be symptoms caused by excessive effects of methadone. High blood levels of methadone can also occasionally cause an irregular heart rhythm that may be serious. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or fast or pounding heartbeats. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

MONITOR: Coadministration with fluconazole, voriconazole, or other azole antifungal agents may increase the serum concentrations of methadone. The mechanism is inhibition of methadone metabolism via CYP450 2C9 and/or 3A4. In a study of volunteers receiving methadone maintenance therapy, mean methadone peak serum concentration (Cmax), systemic exposure (AUC) and trough serum concentration (Cmin) increased by 27%, 35% and 48%, respectively, relative to baseline in the group treated concomitantly with fluconazole 200 mg/day for 14 days. No alterations in methadone pharmacokinetics were reported in the placebo group. In another study involving subjects on methadone maintenance (30 to 100 mg daily), repeat dosing of voriconazole twice daily for 5 days increased the Cmax and AUC of the pharmacologically active R(+) enantiomer of methadone by 31% and 47%, respectively. The Cmax and AUC of the S(-) enantiomer increased by 65% and 103%, respectively. Although significant adverse effects were not reported in the studies, high dosages and serum levels of methadone have been associated with QT interval prolongation and torsades de pointes arrhythmia. Respiratory depression has also been described in a cancer patient treated with methadone 2 days following initiation of intravenous fluconazole (100 mg once a day) therapy. Naloxone was necessary to reverse the effects.

MANAGEMENT: Caution is advised if methadone must be used in combination with fluconazole, voriconazole, or other azole antifungal agents. Pharmacologic response to methadone should be closely monitored and the dosage adjusted accordingly, particularly following initiation or discontinuation of azole therapy in patients who are stabilized on their methadone regimen. Patients should be advised to report excessive drowsiness, nausea, or asthenia to their physician, and to seek medical attention if they experience symptoms that could indicate the occurrence of torsades de pointes such as dizziness, palpitations, irregular heartbeat, shortness of breath, or syncope.

Methadone Tablets

Generic Name: methadone

Brand name: Dolophine, Methadose, Methadose Sugar-Free, Diskets

Synonyms: Methadone

What is Methadone Tablets?

Miconazole oral buccal

Generic Name: miconazole

Brand name: Oravig, Monistat IV, Oravig

Synonyms: Miconazole oral (buccal), Miconazole (Oral)

What is Miconazole oral buccal?