The Bawling Baby

Fatal Forty DDI: rifampin, methadone, CYP3A4, CYP2B6


This case discusses the pharmacokinetic interaction between methadone and rifampin resulting in methadone withdrawal symptoms. Methadone is a cytochrome P450 3A4 and 2B6 substrate and rifampin is a 3A4 and 2B6 inducer. Rifampin induces metabolism of methadone via 3A4 and 2B6 and can cause methadone withdrawal symptoms.


Pharmacokinetic Induction CYP3A4 CYP2B6 Methadone Rifampin Opioid Withdrawal Cytochrome P450 3A4 2B6 


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Anesthesiology and Perioperative Medicine (APOM)Doernbecher Children’s Hospital, Oregon Health and Science UniversityPortlandUSA

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