Drug interactions
Amitriptyline + Hydrocodone
Severity: Moderate
Amitriptyline and Hydrocodone: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Amitriptyline and hydrocodone cause additive CNS and respiratory depression, with added anticholinergic effects such as constipation and urinary retention. Serotonin syndrome is a possible but uncommon risk, and amitriptyline may modestly inhibit CYP2D6.
What this interaction means in plain words
Amitriptyline and Hydrocodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Hydrocodone belongs to Musculoskeletal.
Why it happens
Additive CNS depression and anticholinergic effects, with possible additive serotonergic effects.
What to do
Use the lowest effective doses and monitor sedation, respiratory rate and anticholinergic symptoms. Be alert for signs of serotonin toxicity.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Hydrocodone?
MediHelp rates the interaction as moderate. Amitriptyline and Hydrocodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Amitriptyline and hydrocodone cause additive CNS and respiratory depression, with added anticholinergic effects such as constipation and urinary retention. Serotonin syndrome is a possible but uncommon risk, and amitriptyline may modestly inhibit CYP2D6.
How serious is the interaction between Amitriptyline and Hydrocodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor sedation, respiratory rate and anticholinergic symptoms. Be alert for signs of serotonin toxicity.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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