Methadone and Midazolam must not be used together. This combination is classified as CONTRAINDICATED.
The combination significantly increases the risk of profound sedation, respiratory depression, coma, and death. Patients may experience decreased level of consciousness, hypoventilation, hypoxia, and hypotension. These effects can be rapid in onset and life-threatening.
Mechanism: Methadone, an opioid agonist, primarily acts on mu-opioid receptors, causing central nervous system (CNS) depression, including respiratory depression. Midazolam, a benzodiazepine, enhances the effect of the inhibitory neurotransmitter GABA at GABA-A receptors, leading to further CNS depression. The synergistic CNS depressant effects of both drugs significantly increase the risk of severe adverse outcomes.
Methadone vs. Midazolam
Compare Methadone and Midazolam: mechanism of action, indications, side effects, cost, and which may be right for you.
Quick Comparison
| Category | Methadone | Midazolam |
|---|---|---|
| Drug Class | Opioid Analgesics | Benzodiazepines |
| Rx Status | Rx | Rx |
| Generic Available | No | No |
| Typical Cost | $15–$60/month | $500–$1,500/month |
Methadone Overview
METHADONE (brand name: Methadone Hydrochloride) is a Opioid Analgesics. 1 INDICATIONS AND USAGE Methadone hydrochloride tablets is indicated for the: Management of severe and persistent pain that requires an opioid analgesic and that cannot be adequately treated with alternative options, including immediate-release opioids. Limitations of Use Because of the risks of…
Full Methadone guide →Midazolam Overview
Midazolam is a type of medicine called a benzodiazepine that helps calm the body and mind. It is primarily used to make you feel relaxed and drowsy before medical procedures, surgeries, or to help you fall asleep for general anesthesia. It works by slowing down brain activity to reduce anxiety and create a state of peacefulness or forgetfulness.
Full Midazolam guide →How Each Drug Works
Methadone
Methadone hydrochloride is a mu-agonist; a synthetic opioid with multiple actions qualitatively similar to those of morphine, the most prominent of which involves the central nervous system and organs composed of smooth muscle. The principal therapeutic uses for methadone are for analgesia and for detoxification or maintenance in opioid addiction. The methadone withdrawal syndrome, although qualitatively similar to that of morphine, differs in that the onset is slower, t…
Approved Uses (Indications)
Methadone
Methadone hydrochloride tablets is indicated for the: Management of severe and persistent pain that requires an opioid analgesic and that cannot be adequately treated with alternative options, including immediate-release opioids. Limitations of Use Because of the risks of addiction, abuse, misuse, overdose, and death, which can occur at any dosage or duration and persist over the course of therapy [see WARNINGS AND PRECAUTIONS ], reserve opioid analgesics, including methadone hydrochloride tablets, for use in patients for whom alternative analgesic treatment opti…
Midazolam
INDICATIONS AND USAGE Midazolam Injection is indicated: intramuscularly or intravenously for preoperative sedation/anxiolysis/amnesia; intravenously as an agent for sedation/anxiolysis/amnesia prior to or during diagnostic, therapeutic or endoscopic procedures, such as bronchoscopy, gastroscopy, cystoscopy, coronary angiography, cardiac catheterization, oncology procedures, radiologic procedures, suture of lacerations and other procedures either alone or in combination with other CNS depressants; intravenously for induction of general anesthesia, before administration of other anesthetic agent…
Side Effects
Methadone
Midazolam
Cost Comparison
Methadone
$15–$60/month
Generic methadone is very affordable, especially with discount cards like GoodRx. Many pharmacies offer low-cost programs for this medication.
Midazolam
$500–$1,500/month
As Midazolam is a brand-only medication, explore manufacturer patient assistance programs or discount cards like GoodRx to help reduce the high cost. Your insurance plan's coverage will also significantly impact your out-of-pocket expenses.
Compare prices for Methadone and Midazolam
Check real-time pharmacy prices before you fill — free, no account needed.
Medical Disclaimer
The information on RxGuide is intended for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, pharmacist, or other qualified health provider with any questions you may have regarding a medical condition or medication. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.