Methadone and Zolpidem interaction

Methadone and Zolpidem: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Methadone (METHADOSE) label · effective 2026-04-27

Major

Managing Risks from Concomitant Use with Benzodiazepines or Other CNS Depressants Concomitant use with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, is a risk factor for respiratory depression and death [see Warnings and Precautions ( 5.2 )].

Boxed warningby drug classView label on DailyMed
Major

Reserve concomitant prescribing of benzodiazepines or other CNS depressants in patients in methadone treatment to those for whom alternatives to benzodiazepines or other CNS depressants are inadequate.

Boxed warningby drug classView label on DailyMed
Major

Concomitant use with benzodiazepines or other central nervous system (CNS) depressants, including alcohol, may result in profound sedation, respiratory depression, and death.

Boxed warningby drug classView label on DailyMed
Moderate

…Concomitant Use of Benzodiazepines or Other CNS Depressants with Methadone Concomitant use of methadone and benzodiazepines and/or other CNS depressants (e.g., alcohol, non-benzodiazepine sedative/hypnotics, anxiolytics, tranquilizers, muscle relaxants, general anesthetics, antipsychotics, gabapentinoids [gabapentin or pregabalin], and other opioids), increases the risk…

Warnings and precautionsby drug classView label on DailyMed
Moderate

As a routine part of orientation to methadone treatment, educate patients about the risks of concomitant use of benzodiazepines, sedatives, opioid analgesics, or alcohol.

Warnings and precautionsby drug classView label on DailyMed

From the Zolpidem (zolpidem tartrate) label · effective 2025-11-19

Major

The use of Zolpidem Tartrate with other sedative-hypnotics (including other zolpidem products) at bedtime or the middle of the night is not recommended.

Warnings and precautionsby drug classView label on DailyMed
Major

Opioids: Concomitant use may increase risk of respiratory depression ( 5.7 , 7.1 )

Drug interactionsby drug classView label on DailyMed
Major

Opioids The concomitant use of Zolpidem Tartrate with opioids may increase the risk of respiratory depression.

Drug interactionsby drug classView label on DailyMed
Moderate

CNS-Depressant Effects: Impaired alertness and motor coordination, including risk of morning impairment.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Risk increases with dose and use with other CNS depressants and alcohol.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.