Methadone with Lemborexant Interaction Details
Brand Names Associated with Methadone
- Diskets®
- Dolophine®
- Methadone
- Methadose®
- Methadose® Oral Concentrate
- Westadone®
Brand Names Associated with Lemborexant
- Dayvigo®
- Lemborexant
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Jan 02, 2024
Interaction Effect
Decreased CYP2B6 substrate exposure and risk of reduced efficacy; CNS depression
Interaction Summary
Concomitant use of lemborexant (a CYP2B6 inducer) with a CYP2B6 substrate decreases the AUC of CYP2B6 substrates, and may result in reduced efficacy of the CYP2B6 substrate. Patients receiving lemborexant and CYP2B6 substrates concurrently should be monitored for adequate clinical response. Increasing the doses of CYP2B6 substrates may be considered as needed. Additionally, lemborexant is a CNS depressant that can impair daytime wakefulness and may persist in some patients for up to several days after discontinuing therapy. Coadministration with other CNS depressants increases the risk of CNS depression, which may cause daytime impairment. Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive effects.
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Concomitant use of lemborexant (a CYP2B6 inducer) with a CYP2B6 substrate decreases the AUC of CYP2B6 substrates, and may result in reduced efficacy of the CYP2B6 substrate. Patients receiving lemborexant and CYP2B6 substrates concurrently should be monitored for adequate clinical response. Increasing the doses of CYP2B6 substrates may be considered as needed. Additionally, lemborexant is a CNS depressant that can impair daytime wakefulness and may persist in some patients for up to several days after discontinuing therapy. Coadministration with other CNS depressants increases the risk of CNS depression, which may cause daytime impairment. Dosage adjustments of lemborexant and of concomitant CNS depressants may be necessary when administered together because of potentially additive effects.
Mechanism Of Interaction
Induction of CYP2B6-mediated metabolism by lemborexant; additive CNS depression
Literature Reports
A) Physiologically-based pharmacokinetic modeling predicted that drug interactions between lemborexant and CYP2B6 substrates are clinically significant .
Methadone Overview
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Methadone is used to relieve severe pain in people who are expected to need pain medication around the clock for a long time and who cannot be treated with other medications. It also is used to prevent withdrawal symptoms in patients who were addicted to opiate drugs and are enrolled in treatment programs in order to stop taking or continue not taking the drugs. Methadone is in a class of medications called opiate (narcotic) analgesics. Methadone works to treat pain by changing the way the brain and nervous system respond to pain. It works to treat people who were addicted to opiate drugs by producing similar effects and preventing withdrawal symptoms in people who have stopped using these drugs.
Lemborexant Overview
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Lemborexant is used to treat insomnia (difficulty falling asleep or staying asleep). Lemborexant belongs to a class of medications called hypnotics. It works by slowing activity in the brain to allow sleep.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.