Methadone Tablets and Sublocade

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.

Talk to your doctor before using buprenorphine together with methadone. Combining these medications may reduce the analgesic effect of methadone and/or increase the risk of a relatively rare but potentially life-threatening irregular heart rhythm. You may be more susceptible if you have a heart condition called congenital long QT syndrome, other cardiac diseases, conduction abnormalities, or electrolyte disturbances (for example, magnesium or potassium loss due to severe or prolonged diarrhea or vomiting). If you have been receiving treatment with methadone, adding buprenorphine may also cause you to experience unpleasant withdrawal symptoms such as watery eyes, runny nose, sneezing, yawning, excessive sweating, goose bumps, fever, chills, flushing, restlessness, irritability, anxiety, depression, pupil dilation, tremor, rapid heart beat, body aches, involuntary twitching and kicking, abdominal cramping, loss of appetite, nausea, vomiting, diarrhea, and weight loss. You should seek immediate medical attention if you develop sudden dizziness, lightheadedness, fainting, shortness of breath, or heart palpitations during treatment with these medications. 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.

GENERALLY AVOID: Mixed agonist-antagonist opioids may reduce the analgesic effect of pure opioid agonists. In addition, they may precipitate withdrawal symptoms in patients who are opioid-dependent. The proposed mechanism is competitive antagonism of opioid receptor sites by mixed agonist-antagonists.

MONITOR CLOSELY: Buprenorphine or methadone may cause prolongation of the QT interval. Theoretically, coadministration of agents that can prolong the QT interval may result in additive effects and increased risk of ventricular arrhythmias including torsade de pointes and sudden death. Therapeutic dosages of buprenorphine buccal film have been associated with QTc prolongation. In a controlled, open-label chronic pain study of 1590 patients treated with buprenorphine buccal film at doses up to 900 mcg every 12 hours, 2% of patients developed prolonged post-baseline QTcF (Fridericia-corrected QT interval) values of 450 to 480 msec during treatment. Transdermal buprenorphine (40 mcg/hr) has also been associated with a mean QTc prolongation of up to 9.2 msec in studies involving healthy subjects. In addition, high dosages of methadone alone have been associated with QT interval prolongation and torsade de pointes. In a retrospective study of 17 methadone-treated patients who developed torsade de pointes, the mean daily dose was approximately 400 mg (range 65 to 1000 mg) and the mean corrected QT (QTc) interval on presentation was 615 msec. The daily methadone dose correlated positively with the QTc interval. Fourteen patients had at least one predisposing risk factor for arrhythmia (hypokalemia, hypomagnesemia, concomitant use of a medication known to prolong the QT interval or inhibit the metabolism of methadone, and structural heart disease), but these were not predictive of QTc interval. It is not known if any of the patients had congenital long QT syndrome.

MANAGEMENT: Mixed agonist-antagonist opioids such as buprenorphine should generally be avoided in patients who have recently received or are receiving treatment with a pure opioid agonist. If use of these drugs is unavoidable, caution and clinical monitoring are recommended. In general, the risk of an individual agent or a combination of agents causing ventricular arrhythmia in association with QT prolongation is largely unpredictable but may be increased by certain underlying risk factors such as congenital long QT syndrome, cardiac disease, and electrolyte disturbances (e.g., hypokalemia, hypomagnesemia). In addition, the extent of drug-induced QT prolongation is dependent on the particular drug(s) involved and dosage(s) of the drug(s). Patients should be advised to seek prompt medical attention if they experience symptoms that could indicate the occurrence of torsade de pointes such as dizziness, lightheadedness, fainting, palpitation, irregular heart rhythm, shortness of breath, or syncope.

Methadone Tablets

Generic Name: methadone

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

Synonyms: Methadone

What is Methadone Tablets?

Sublocade

Generic Name: buprenorphine

Brand name: Sublocade, Belbuca, Buprenex, Probuphine, Butrans, Subutex

Synonyms: Sublocade Injection

What is Sublocade?