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Is It Safe to Combine Methadone and Oxycodone?

By S. Berger
Updated Mar 03, 2024
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Classified as opiate analgesics, both methadone and oxycodone are medications used to treat moderate to severe pain. Combining these medications can carry risks of increased side effects that may be lethal in some cases, such as with respiratory depression. In some cases, however, the two medications may be combined safely under a doctor's supervision to treat specific cases of pain. Due to the potential safety hazards, though, they should not be mixed unless a doctor specifically advises it.

Methadone and oxycodone are both used to treat similar levels of pain, but the length of pain relief offered by each varies. The effects of methadone can last for 24 to 36 hours, making it appropriate for treating chronic pain. Oxycodone, in its instant-release formulation, generally lasts for around six to eight hours, and around 12 hours in an extended release formulation. Depending on its formulation, it may be used to treat acute pain that appears suddenly, or chronic pain.

Doctors may use a combination of opioid analgesics to treat certain medical conditions. Conditions that involve a basic level of chronic pain that must be controlled, along with acute pain that may arise unexpectedly, often involve a combination of a long-acting and short-acting opiate. In such a case, doctors may prescribe methadone with oxycodone, with methadone taken on a daily basis for chronic pain, and oxycodone taken as needed when acute pain occurs.

The side effects of these medications often increase when they are combined. For this reason, methadone and oxycodone should only be mixed under the supervision of a medical professional. Common side effects that result from taking either or both medications can include nausea, stomach discomfort, and drowsiness. Large doses of opioids can result in more severe side effects, particularly respiratory depression, or difficulty breathing. In severe cases, respiratory depression can be fatal, and mixing opioids increases the chance of this effect developing.

Drug interactions also become more likely when mixing methadone and oxycodone. Taking both medications at once increases the risk of potentially dangerous sedation when combined with other central nervous system (CNS) depressants such as alcohol, benzodiazepines, and sleeping pills. Certain blood pressure medications may have increased reactions with a combination of these drugs, as well. Both opioid painkillers can be addictive, and the potential for addiction can be much greater when they are taken together, which is another reason that a doctor should monitor any combination of the two.

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Discussion Comments
By anon1003580 — On Jul 26, 2020

All wrong. It is deadly stuff, and should only be given at end of life and not ever in the USA. They have No way to get you off it once you have had it for a time. Note your body will only make more pain receptors and signaling chemicals making pain worse and worse. Even high dose cannabis will do this, even though it is the only drug that actually treats the problem with damaged central nevous system.

By anon997378 — On Dec 28, 2016

If I were any of you who are asking questions on this topic, I would only heed the advice posted by a doctor -- period. Thus far I have heard some very good questions, and also some horrifying answers. I'm not a physician, nor am I qualified to even give answers. That's why doctors go to college for four years and then another four of med school.

By anon989923 — On Mar 27, 2015

I almost died when I took Methadone and oxycontin together; it was the worst feeling of my life yet, and I have been taking those two individually for the past eight years. My advice is, never ever take the two at the same time.

By anon937781 — On Mar 06, 2014

First off, I'm not saying to do it, but all my friends or even family members who are on pain medication have both oxycodone and methadone. Some of them take about 80mg oxycodone in day time and few hours before bed take 10-20mg methadone. I have taken 100mg oxycodone and 40mg methadone at same time and it works. It is perfect for pain

But always do your research first. You can always take small amounts and increase but you cannot take large amounts and decrease!

Obviously you will get mixed answers from people saying it’s bad and people saying it’s O.K., but if doctors prescribe both, it’s obviously O.K., depending strictly on your past narcotic use. Never take a bunch if you’re only using about around 5-20mg oxycodone a day. For most methadone, I’d say for that would be 5mg at most.

By serenesurface — On Jul 13, 2013
My doctor actually gave me both of these drugs for my back pain. I was put on 100mg/daily of oxycodone first. It was working but the drug wasn't lasting me through the night and I would wake up and stay up from the pain. So then, he gave me a small dose, 10mg of methadone to take before bedtime.

This actually worked perfect because methadone has a much longer half-life. It gave me pain-relief that lasted till morning. I did make sure to take all my oxycodone at least four hours before I took my methadone though and I never used more than what my doctor prescribed, so I didn't have any problems.

By SteamLouis — On Jul 13, 2013

@alisha-- It's not safe to combine methadone and oxycodone. It's not safe to combine opiates in general. When opiates mix, the effects and side effect of each increase. There is a risk of overdosing. Even if you don't end up overdosing, the side effects of mixing methadone and oxycodone will be very unpleasant. You can even cause kidney damage by mixing opiates.

Just go back to your doctor and ask for something else or for a different dose of oxycodone. Don't play around with drugs and doses yourself.

By discographer — On Jul 12, 2013

My doctor prescribed a low dose of oxycodone for me first but since it didn't work too well, he switched me to methadone. The methadone worked for the first two days and now it's not working again. Will it be very bad if I take the methadone with the oxycodone that was given to me before? I just want pain relief.

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