PCSS-MOUD On-Demand Webinar: Methadone and Buprenorphine-Associated Drug-Drug Interactions-Presentation

Video Transcription

Video Summary

The webinar focused on methadone and buprenorphine-associated drug-drug interactions in opioid use disorder treatment. Dr. Thaddeus Ihinyacho explained that opioid overdose remains a major public health problem, with synthetic opioids like fentanyl driving much of the rise in deaths. The presentation reviewed why drug interactions happen through pharmacokinetics (what the body does to the drug) and pharmacodynamics (what the drug does to the body).<br /><br />Key risks include combining opioids with benzodiazepines, alcohol, gabapentin, sedating antipsychotics, or other respiratory depressants, which increases overdose danger. Methadone has more clinically significant interactions than buprenorphine because it is metabolized by multiple CYP enzymes and can also prolong the QT interval, raising arrhythmia risk. Common interacting drugs include SSRIs such as fluoxetine and fluvoxamine, rifampin, carbamazepine, and some HIV medications. Buprenorphine generally has fewer interactions due to strong receptor binding and partial agonist activity.<br /><br />The speaker emphasized practical strategies: medication reconciliation, care coordination, patient education, avoiding polypharmacy when possible, and choosing safer alternatives. Overall, buprenorphine is often preferred when patients need multiple medications, though monitoring is still essential.

Keywords

methadone

buprenorphine

drug-drug interactions

opioid use disorder

pharmacokinetic interactions

pharmacodynamic interactions

QT prolongation

benzodiazepines

overdose risk

opioid overdose

CYP enzymes

QT interval prolongation

polypharmacy