Drug interactions
Benzhydrocodone / acetaminophen + Hydrocodone
Severity: Major
Benzhydrocodone / acetaminophen and Hydrocodone: 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, so the two together amount to duplicate opioid therapy. This increases the risk of overdose, respiratory depression, sedation and death, with extra acetaminophen exposure in the combination product.
What this interaction means in plain words
Benzhydrocodone / acetaminophen 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.
Why it happens
Therapeutic duplication: benzhydrocodone is converted to hydrocodone, producing additive mu-opioid effects.
What to do
Avoid concurrent use and use a single opioid product. If a switch is made, stop the previous opioid and dose according to total opioid exposure.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Benzhydrocodone / acetaminophen and Hydrocodone, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Hydrocodone?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen 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. Benzhydrocodone is a prodrug of hydrocodone, so the two together amount to duplicate opioid therapy. This increases the risk of overdose, respiratory depression, sedation and death, with extra acetaminophen exposure in the combination product.
How serious is the interaction between Benzhydrocodone / acetaminophen 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: Avoid concurrent use and use a single opioid product. If a switch is made, stop the previous opioid and dose according to total opioid exposure.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
