Drug interactions
Atazanavir + Hydrocodone
Severity: Major
Atazanavir and Hydrocodone: major interaction.
Last updated Sources: US FDA label
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
Atazanavir inhibits CYP3A4, the main route of hydrocodone clearance, and can raise hydrocodone concentrations. This increases the risk of profound sedation and respiratory depression.
What this interaction means in plain words
Atazanavir and Hydrocodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Atazanavir belongs to Anti Virals; Hydrocodone belongs to Musculoskeletal.
Why it happens
Inhibition of CYP3A4-mediated metabolism of hydrocodone.
What to do
Use the lowest effective hydrocodone dose and monitor for respiratory depression and sedation, especially at initiation. Reduce the hydrocodone dose if needed, and monitor for loss of analgesia or withdrawal if atazanavir is stopped.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Atazanavir
- Alfuzosin + Atazanavir Contraindicated
- Atazanavir + Avanafil Contraindicated
- Atazanavir + Dronedarone Contraindicated
- Atazanavir + Eletriptan Contraindicated
- Atazanavir + Eplerenone Contraindicated
- Atazanavir + Ergotamine Contraindicated
Frequently asked questions
Can I take Atazanavir with Hydrocodone?
MediHelp rates the interaction as major. Atazanavir and Hydrocodone can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Atazanavir inhibits CYP3A4, the main route of hydrocodone clearance, and can raise hydrocodone concentrations. This increases the risk of profound sedation and respiratory depression.
How serious is the interaction between Atazanavir and Hydrocodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective hydrocodone dose and monitor for respiratory depression and sedation, especially at initiation. Reduce the hydrocodone dose if needed, and monitor for loss of analgesia or withdrawal if atazanavir is stopped.
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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