Drug interactions
Bupropion-naltrexone + Perhexiline
Severity: Major
Bupropion-naltrexone and Perhexiline: 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
Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic range. Bupropion inhibits CYP2D6 and may markedly raise perhexiline levels, risking hepatotoxicity and neuropathy.
What this interaction means in plain words
Bupropion-naltrexone and Perhexiline 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
Bupropion inhibits CYP2D6, reducing perhexiline clearance.
What to do
Monitor plasma perhexiline concentrations and liver function, and reduce the perhexiline dose as guided by levels.
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 Bupropion-naltrexone
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Bupropion-naltrexone + Isocarboxazid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion-naltrexone + Phenelzine Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
Frequently asked questions
Can I take Bupropion-naltrexone with Perhexiline?
MediHelp rates the interaction as major. Bupropion-naltrexone and Perhexiline 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. Perhexiline is cleared mainly by CYP2D6 and has a narrow therapeutic range. Bupropion inhibits CYP2D6 and may markedly raise perhexiline levels, risking hepatotoxicity and neuropathy.
How serious is the interaction between Bupropion-naltrexone and Perhexiline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor plasma perhexiline concentrations and liver function, and reduce the perhexiline dose as guided by levels.
What other medicines interact with Bupropion-naltrexone?
MediHelp also lists interactions of Bupropion-naltrexone with, for example, Hydrocodone, Hydromorphone, Isocarboxazid. The full list is on the Bupropion-naltrexone page.
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