Drug interactions
Benzhydrocodone / acetaminophen + Ketamine
Severity: Major
Benzhydrocodone / acetaminophen and Ketamine: 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
Opioids combined with ketamine can increase sedation and respiratory depression, although ketamine is also used for opioid-sparing analgesia. Hypotension may occur in volume-depleted patients.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Ketamine 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 CNS depression from opioid mu-receptor agonism and NMDA antagonism.
What to do
Use the lowest effective doses, reduce opioid dose as ketamine is introduced and monitor respiratory rate, sedation and blood pressure.
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 Ketamine
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Ketamine?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Ketamine 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. Opioids combined with ketamine can increase sedation and respiratory depression, although ketamine is also used for opioid-sparing analgesia. Hypotension may occur in volume-depleted patients.
How serious is the interaction between Benzhydrocodone / acetaminophen and Ketamine?
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, reduce opioid dose as ketamine is introduced and monitor respiratory rate, sedation and blood pressure.
What other medicines interact with Ketamine?
MediHelp also lists interactions of Ketamine with, for example, Brexanolone, Buprenorphine buccal, Buprenorphine long-acting. The full list is on the Ketamine page.
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