Drug interactions
Butalbital + Hydrocodone
Severity: Major
Butalbital and Hydrocodone: 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
Butalbital is a barbiturate that adds to the sedative and respiratory depressant effects of hydrocodone. Combined use can lead to profound sedation, respiratory depression and death.
What this interaction means in plain words
Butalbital and Hydrocodone 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 via GABA-A potentiation and mu-opioid agonism; butalbital may also induce CYP3A4.
What to do
Avoid or restrict to patients without alternatives, using minimal doses and duration. Monitor for sedation and respiratory depression.
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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Butalbital with Hydrocodone?
MediHelp rates the interaction as major. Butalbital and Hydrocodone 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. Butalbital is a barbiturate that adds to the sedative and respiratory depressant effects of hydrocodone. Combined use can lead to profound sedation, respiratory depression and death.
How serious is the interaction between Butalbital and Hydrocodone?
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 or restrict to patients without alternatives, using minimal doses and duration. Monitor for sedation and respiratory depression.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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