Sulfameth Trimethoprim And Methadone

I am currently on 20mg of Methadone and went to the dr yesterday and was prescribed Sulfameth/Trimethoprim. My dr. knows that I am on Methadone from my last appt with her a couple months ago. I just want to make sure that it is ok to take these together.

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Hi Nicole,

From what I could gather, there is said to be a "minor" interaction between Methadone and Sulfa-Tmp. Some minor drug interactions may not be clinically relevant in all patients, since minor drug interactions do not usually cause harm or require a change in therapy. However, your healthcare provider can determine if adjustments to your medications are needed.

The information I found on this interaction is quoted below, although I personally don't find their wording to make the most of sense:

"Limited data suggest that sulfamethoxazole-trimethoprim (SMX-TMP) may rarely prolong the QT interval of the electrocardiogram. Theoretically, coadministration with other 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. There have been isolated reports of QT prolongation and ventricular arrhythmias occurring in patients treated with SMX-TMP intravenously. However, a causal relationship has not been established, and the risk of clinically significant QT prolongation is unlikely at recommended dosages of SMX-TMP. 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."

If you remain at all concerned I would just bring this up to your doctor for his opinion. But all in all, I think you should be fine. I hope this info helps!

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Thanks so much!

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And I'm also on another antibiotic too, but could not find any helpful info between this one and my methadone........the other antibiotic is metronidazole........any reason for concern for taking this combo?

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Its really not a reply, but another question has anyone recently been prescribed Flagyl while on Methadone? I'm on 70mg & dropping but have to have rrot canal was prescribed 500mg 4×a day Flagyl. I was told by my dosing nurse at clinic it was ok too take 2 n morning and 2 at night. I understand she should definitely know, but after the stuff i went through in the hospital while giving birth stupid nurses told me they've been with Methadone moms before and said giving me Nubain (?) was ok. Well it wasn't and they caused me great trauma from that and ever since then I freak out if I've got to take anything with the Methadone. I asked around the clinic and nobody's been on them both before so if anyone out in the world has PLEASE let me know how it went. Thank you

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