Drug interactions
Benzhydrocodone / acetaminophen + Cimetidine
Severity: Moderate
Benzhydrocodone / acetaminophen and Cimetidine: 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
Benzhydrocodone is a prodrug of hydrocodone, which is metabolized by CYP3A4 to norhydrocodone and by CYP2D6 to hydromorphone. Cimetidine's inhibition of these enzymes may shift hydrocodone exposure, and CYP3A4 inhibition in particular may raise hydrocodone levels and increase sedation and respiratory depression.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Cimetidine 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
Cimetidine inhibits CYP3A4 and CYP2D6, altering hydrocodone metabolism.
What to do
Monitor for excess sedation and respiratory depression when starting or stopping cimetidine, and reduce the opioid dose if needed. Famotidine is an alternative.
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 Cimetidine
- Cimetidine + Dofetilide Contraindicated
- Cimetidine + Fezolinetant Contraindicated
- Alfentanil + Cimetidine Major
- Atazanavir + Cimetidine Major
- Carmustine + Cimetidine Major
- Cimetidine + Citalopram Major
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Cimetidine?
MediHelp rates the interaction as moderate. Benzhydrocodone / acetaminophen and Cimetidine 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. Benzhydrocodone is a prodrug of hydrocodone, which is metabolized by CYP3A4 to norhydrocodone and by CYP2D6 to hydromorphone. Cimetidine's inhibition of these enzymes may shift hydrocodone exposure, and CYP3A4 inhibition in particular may raise hydrocodone levels and increase sedation and respiratory depression.
How serious is the interaction between Benzhydrocodone / acetaminophen and Cimetidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor for excess sedation and respiratory depression when starting or stopping cimetidine, and reduce the opioid dose if needed. Famotidine is an alternative.
What other medicines interact with Cimetidine?
MediHelp also lists interactions of Cimetidine with, for example, Dofetilide, Fezolinetant, Alfentanil. The full list is on the Cimetidine page.
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