Drug interactions
Benzhydrocodone / acetaminophen + Isoniazid
Severity: Major
Benzhydrocodone / acetaminophen and Isoniazid: 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
Isoniazid inhibits CYP3A4, which clears hydrocodone, so opioid exposure can increase and risk respiratory depression and sedation. Isoniazid and acetaminophen both carry hepatotoxic potential, with isoniazid possibly increasing toxic acetaminophen metabolite formation.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Isoniazid 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 raises hydrocodone levels, and isoniazid-related CYP2E1 effects plus additive hepatotoxicity apply to acetaminophen.
What to do
Use the lowest effective opioid dose and monitor for sedation and respiratory depression. Monitor liver function and limit acetaminophen total daily dose.
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 Isoniazid
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Isoniazid?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Isoniazid 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. Isoniazid inhibits CYP3A4, which clears hydrocodone, so opioid exposure can increase and risk respiratory depression and sedation. Isoniazid and acetaminophen both carry hepatotoxic potential, with isoniazid possibly increasing toxic acetaminophen metabolite formation.
How serious is the interaction between Benzhydrocodone / acetaminophen and Isoniazid?
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 opioid dose and monitor for sedation and respiratory depression. Monitor liver function and limit acetaminophen total daily dose.
What other medicines interact with Isoniazid?
MediHelp also lists interactions of Isoniazid with, for example, Bacillus calmette-guerin substrain tice, Carbamazepine, Didanosine. The full list is on the Isoniazid page.
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