Drug interactions
Benzhydrocodone / acetaminophen + Posaconazole
Severity: Major
Benzhydrocodone / acetaminophen and Posaconazole: major interaction.
Last updated Sources: US FDA label
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 converted to hydrocodone, which is cleared by CYP3A4. Posaconazole can raise hydrocodone concentrations, increasing the risk of profound sedation and potentially fatal respiratory depression. Stopping the inhibitor later may reduce opioid levels and lead to loss of analgesia or withdrawal.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Posaconazole 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
Strong CYP3A4 inhibition decreases hydrocodone metabolism to norhydrocodone, increasing parent opioid exposure.
What to do
Avoid the combination where possible, or reduce the opioid dose and monitor closely for respiratory depression and sedation. Reassess dosing when posaconazole 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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References
Other interactions of Posaconazole
- Artemether + Posaconazole Contraindicated
- Avanafil + Posaconazole Contraindicated
- Cobimetinib + Posaconazole Contraindicated
- Conivaptan + Posaconazole Contraindicated
- Dihydroergotamine intranasal + Posaconazole Contraindicated
- Dihydroergotamine + Posaconazole Contraindicated
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Posaconazole?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Posaconazole 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 converted to hydrocodone, which is cleared by CYP3A4. Posaconazole can raise hydrocodone concentrations, increasing the risk of profound sedation and potentially fatal respiratory depression. Stopping the inhibitor later may reduce opioid levels and lead to loss of analgesia or withdrawal.
How serious is the interaction between Benzhydrocodone / acetaminophen and Posaconazole?
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, or reduce the opioid dose and monitor closely for respiratory depression and sedation. Reassess dosing when posaconazole is started or stopped.
What other medicines interact with Posaconazole?
MediHelp also lists interactions of Posaconazole with, for example, Artemether, Avanafil, Cobimetinib. The full list is on the Posaconazole page.
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