Mixing Methadone and Zolpidem (Ambien)

Q: How dangerous is Methadone with Zolpidem?

Dangerous: High risk of death or life-changing injury. Do not combine.

Q: Is it safe to mix Methadone and Ambien?

MixSafe lists Ambien under Zolpidem. That combination is rated "Dangerous". Additive respiratory depression against methadone's long, invisible tail. The combination is well documented in methadone-treatment mortality data and is worst in the induction period.

Dangerous

Together they slow breathing, on top of methadone's long, unfelt tail.

Do this

Do not combine, especially early in methadone treatment.

General answer for Benzodiazepines: nothing specific to these two is documented.

Where the risk isTap for why

In an emergency, call 911911 Never Use Alone Poison Control

What to do

Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.

What “Dangerous” means

High risk of death or life-changing injury. Do not combine.

How the ratings work

The longer explanation

Additive respiratory depression against methadone's long, invisible tail. The combination is well documented in methadone-treatment mortality data and is worst in the induction period.

Sources (2)

QT prolongation with methadonepmc.ncbi.nlm.nih.gov
Methadone Safety: A Clinical Practice Guideline From the American Pain Society and College on Problems of Drug Dependence, in Collaboration With the Heart Rhythm Societysciencedirect.com

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Other names

Methadone: dolophine, methadose, done; Long-acting — outlasts its own effects by many hours
Zolpidem: ambien, ambien cr, stilnox, edluar, intermezzo, zolpimist; Works like a benzo, plus sleepwalking and sleep-driving with no memory of it

Add a third substance in the checker

Related combinations

Methadone with

What not to mix with Methadone →

Zolpidem with

What not to mix with Zolpidem →

All combinations →

Can you mix Methadone and Zolpidem (Ambien)?

MixSafe rates mixing Methadone and Zolpidem as "Dangerous" — high risk of death or life-changing injury. Do not combine. No interaction specific to Methadone and Zolpidem is documented; this is the default for Benzodiazepines. Source: MixSafe research. Educational information, not medical advice.

This is a class-level answer, inherited from Benzodiazepines. Nothing specific to this exact pair is documented, so treat it as the default for the class rather than a measurement of these two drugs together.