What the FDA labels say about taking them together
Escitalopram and methadone
Escitalopram's FDA label of October 1, 2023 names methadone in its warnings and precautions section; methadone's label does not name escitalopram itself but warns about its class (serotonin reuptake inhibitors). The escitalopram label: “The risk is increased with concomitant use of other serotonergic drugs and with drugs that impair metabolism of serotonin, i.e., MAOIs.”
Check it at the source: the escitalopram FDA label on DailyMed (effective October 1, 2023, Allergan, Inc.); the methadone FDA label on DailyMed (effective December 8, 2025, Epic Pharma, LLC).
What does the escitalopram label say about methadone?
Escitalopram label, warnings and precautionsThe risk is increased with concomitant use of other serotonergic drugs (including triptans, tricyclic antidepressants, fentanyl, meperidine, methadone, lithium, tramadol, tryptophan, buspirone, amphetamines, and St. John’s Wort) and with drugs that impair metabolism of serotonin, i.e., MAOIs [see Contraindications ( 4 ) and Drug Interactions ( 7 )].
Source: FDA drug label (Lexapro), NDA021323 (Abbvie), as published by Allergan, Inc., effective October 1, 2023 (SPL set 13bb8267-1cab-43e5-acae-55a4d957630a), via openFDA; the full label on DailyMed
What does the methadone label say about escitalopram?
Methadone's label does not name escitalopram itself; it warns about its class (serotonin reuptake inhibitors):
Methadone label, warnings and precautionsSyndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of methadone hydrochloride tablets with serotonergic drugs. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonergic neurotransmitter system (e.g., mirtazapine …
Methadone label, warnings and precautionsSyndrome with Concomitant Use of Serotonergic Drugs Cases of serotonin syndrome, a potentially life-threatening condition, have been reported during concomitant use of DISKETS with serotonergic drugs. Serotonergic drugs include selective serotonin reuptake inhibitors (SSRIs), serotonin and norepinephrine reuptake inhibitors (SNRIs), tricyclic antidepressants (TCAs), triptans, 5-HT3 receptor antagonists, drugs that affect the serotonergic neurotransmitter system (e.g., mirtazapine, trazodone, tramadol), certain …
Source: FDA drug label (Methadone Hydrochloride), Epic Pharma, LLC, effective December 8, 2025 (SPL set 6da7501b-b881-4bc7-891a-74214a00a3ac), via openFDA; the full label on DailyMed
These are the labels' own sentences. PlainMeds does not grade interactions; a pharmacist or prescriber can say what they mean for one person's medicines.
Both medicines on the record
| Escitalopram | Methadone | |
|---|---|---|
| Labeled for | Depression, Anxiety | Pain, Opioid use disorder |
| Boxed warning | Yes | Yes |
| Pharmacy cost (NADAC) | $0.0632 per tablet 20 mg tablet | $0.177 per tablet 10 mg tablet |
| Shortage now | No current entry | No current entry |
Source: FDA NDC Directory, CMS NADAC of October 7, 2026 and the FDA Drug Shortage Database (FDA files October 8, 2026)
What next?
- Check more medicines together
- up to five at once