Drug interactions
Asenapine transdermal + Hydromorphone
Severity: Moderate
Asenapine transdermal and Hydromorphone: 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
Asenapine is a sedating antipsychotic and hydromorphone is a potent opioid, so combined use increases drowsiness, hypotension and the risk of respiratory depression. Systemic exposure from the patch is sustained, so the effect can persist.
What this interaction means in plain words
Asenapine transdermal and Hydromorphone 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.
Why it happens
Additive CNS depression via opioid receptor agonism and antipsychotic antagonism at histaminergic, adrenergic and other receptors.
What to do
Start with the lowest effective doses and monitor sedation, blood pressure and respiratory rate, especially after dose changes. Reduce the opioid dose if excessive sedation occurs.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Asenapine transdermal with Hydromorphone?
MediHelp rates the interaction as moderate. Asenapine transdermal and Hydromorphone 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. Asenapine is a sedating antipsychotic and hydromorphone is a potent opioid, so combined use increases drowsiness, hypotension and the risk of respiratory depression. Systemic exposure from the patch is sustained, so the effect can persist.
How serious is the interaction between Asenapine transdermal and Hydromorphone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with the lowest effective doses and monitor sedation, blood pressure and respiratory rate, especially after dose changes. Reduce the opioid dose if excessive sedation occurs.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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