How does methadone hydrochloride interact with other medications or food?

Many medications can interact with methadone hydrochloride. Medications that may make methadone hydrochloride less effective include abacavir, carbamazepine, efavirenz, HIV protease inhibitors, narcotic agonists/antagonists, nevirapine, phenobarbital, phenytoin, rifampin, and St. John's wort. Methadone hydrochloride may decrease the effectiveness of nucleoside reverse transcriptase inhibitors (NRTIs). Side effects may be increased if methadone hydrochloride is taken with barbiturates, benzodiazepines, cimetidine, zivovudine, narcotic analgesics, phenothiazines, azole antifungals, or serotonin selective reuptake inhibitors (SSRIs). The following drugs can cause increased risk of QT prolongation if taken with methadone hydrochloride: antiarrhythmics, antipsychotics, calcium channel blockers, antiemetics, chloroquine, diuretics, H1 antagonists, kinase inhibitors, lithium, macrolide antibiotics, phenothiazines, quinolones, streptogramins, tacrolimus, and tricyclic antidepressants. In addition, alcohol can cause serious side effects when combined with methadone hydrochloride. You should avoid drinking alcohol and make sure that no foods you eat contain alcohol.

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