Drug interactions
Benzhydrocodone / acetaminophen + Imatinib
Severity: Major
Benzhydrocodone / acetaminophen and Imatinib: 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, which is metabolised by CYP3A4 to norhydrocodone. Imatinib inhibits CYP3A4, which can raise hydrocodone levels and increase sedation and respiratory depression.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Imatinib 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
CYP3A4 inhibition by imatinib reduces hydrocodone clearance, with a minor contribution from CYP2D6 inhibition.
What to do
Monitor closely for sedation and respiratory depression, and reduce the opioid dose if needed. Take care when imatinib is started or 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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Other interactions of Imatinib
- Imatinib + Lomitapide Contraindicated
- Imatinib + Lonafarnib Contraindicated
- Amobarbital + Imatinib Major
- Apalutamide + Imatinib Major
- Avapritinib + Imatinib Major
- Bosutinib + Imatinib Major
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Imatinib?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Imatinib 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, which is metabolised by CYP3A4 to norhydrocodone. Imatinib inhibits CYP3A4, which can raise hydrocodone levels and increase sedation and respiratory depression.
How serious is the interaction between Benzhydrocodone / acetaminophen and Imatinib?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor closely for sedation and respiratory depression, and reduce the opioid dose if needed. Take care when imatinib is started or stopped.
What other medicines interact with Imatinib?
MediHelp also lists interactions of Imatinib with, for example, Lomitapide, Lonafarnib, Amobarbital. The full list is on the Imatinib page.
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