Drug interactions
Benzhydrocodone / acetaminophen + Duloxetine
Severity: Major
Benzhydrocodone / acetaminophen and Duloxetine: major 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, an opioid with weak serotonergic activity, and duloxetine is a serotonin-norepinephrine reuptake inhibitor. Combining them raises the risk of serotonin syndrome and additive CNS depression. Duloxetine also moderately inhibits CYP2D6, which may alter hydrocodone's active metabolite formation.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Duloxetine 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.
Why it happens
Additive serotonergic effects and CNS depression, with CYP2D6 inhibition by duloxetine altering hydrocodone metabolism.
What to do
Use the lowest effective doses and monitor for serotonin syndrome and respiratory depression, especially at initiation and dose changes. Stop the combination if serotonin toxicity is suspected.
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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Other interactions of Duloxetine
- Duloxetine + Isocarboxazid Contraindicated
- Duloxetine + Linezolid Contraindicated
- Duloxetine + Methylene blue Contraindicated
- Duloxetine + Phenelzine Contraindicated
- Duloxetine + Procarbazine Contraindicated
- Duloxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Duloxetine?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Duloxetine 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. Benzhydrocodone is a prodrug of hydrocodone, an opioid with weak serotonergic activity, and duloxetine is a serotonin-norepinephrine reuptake inhibitor. Combining them raises the risk of serotonin syndrome and additive CNS depression. Duloxetine also moderately inhibits CYP2D6, which may alter hydrocodone's active metabolite formation.
How serious is the interaction between Benzhydrocodone / acetaminophen and Duloxetine?
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 doses and monitor for serotonin syndrome and respiratory depression, especially at initiation and dose changes. Stop the combination if serotonin toxicity is suspected.
What other medicines interact with Duloxetine?
MediHelp also lists interactions of Duloxetine with, for example, Isocarboxazid, Linezolid, Methylene blue. The full list is on the Duloxetine page.
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