Drug interactions
Benzhydrocodone / acetaminophen + Remifentanil
Severity: Major
Benzhydrocodone / acetaminophen and Remifentanil: 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
Both contain opioid agonists, so combining them increases the risk of profound sedation, respiratory depression, coma and death. Remifentanil acts rapidly and can potentiate effects of oral opioid therapy.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Remifentanil 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 mu-opioid receptor-mediated CNS and respiratory depression.
What to do
Use the lowest effective doses for the shortest duration and titrate remifentanil carefully in patients on benzhydrocodone. Monitor respiratory rate and sedation continuously.
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 Remifentanil
- Alvimopan + Remifentanil Contraindicated
- Isocarboxazid + Remifentanil Contraindicated
- Olanzapine / samidorphan + Remifentanil Contraindicated
- Phenelzine + Remifentanil Contraindicated
- Brexanolone + Remifentanil Major
- Buprenorphine long-acting + Remifentanil Major
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Remifentanil?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Remifentanil 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. Both contain opioid agonists, so combining them increases the risk of profound sedation, respiratory depression, coma and death. Remifentanil acts rapidly and can potentiate effects of oral opioid therapy.
How serious is the interaction between Benzhydrocodone / acetaminophen and Remifentanil?
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 for the shortest duration and titrate remifentanil carefully in patients on benzhydrocodone. Monitor respiratory rate and sedation continuously.
What other medicines interact with Remifentanil?
MediHelp also lists interactions of Remifentanil with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Remifentanil page.
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