Drug interactions
Benzhydrocodone / acetaminophen + Itraconazole
Severity: Major
Benzhydrocodone / acetaminophen and Itraconazole: 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 cleared by CYP3A4. Itraconazole can raise hydrocodone levels, which may cause profound sedation and potentially fatal respiratory depression.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Itraconazole 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
Itraconazole strongly inhibits CYP3A4, reducing hydrocodone clearance.
What to do
Avoid the combination where possible; if used, monitor closely for respiratory depression and sedation and reduce the opioid dose. Be cautious when itraconazole is stopped, as hydrocodone levels will fall.
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 Itraconazole
- Alfuzosin + Itraconazole Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Avanafil + Itraconazole Contraindicated
- Conivaptan + Itraconazole Contraindicated
- Dihydroergotamine intranasal + Itraconazole Contraindicated
- Dihydroergotamine + Itraconazole Contraindicated
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Itraconazole?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Itraconazole 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 cleared by CYP3A4. Itraconazole can raise hydrocodone levels, which may cause profound sedation and potentially fatal respiratory depression.
How serious is the interaction between Benzhydrocodone / acetaminophen and Itraconazole?
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 the combination where possible; if used, monitor closely for respiratory depression and sedation and reduce the opioid dose. Be cautious when itraconazole is stopped, as hydrocodone levels will fall.
What other medicines interact with Itraconazole?
MediHelp also lists interactions of Itraconazole with, for example, Alfuzosin, Alprazolam, Avanafil. The full list is on the Itraconazole page.
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