Drug interactions
Calcium / magnesium / potassium / sodium oxybates + Hydromorphone
Severity: Major
Calcium / magnesium / potassium / sodium oxybates and Hydromorphone: 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
Oxybates are potent CNS depressants, and with an opioid they can cause profound sedation, respiratory depression, coma and death. The risk rises with dose and in patients with respiratory disease.
What this interaction means in plain words
Calcium / magnesium / potassium / sodium oxybates and Hydromorphone 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 and respiratory depression from GABA-B/GHB receptor activity and mu-opioid agonism.
What to do
Avoid the combination where possible; if an opioid is unavoidable, use the lowest doses and shortest duration and monitor closely for respiratory depression and sedation. Consider reducing or interrupting the oxybate during opioid treatment.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Calcium / magnesium / potassium / sodium oxybates with Hydromorphone?
MediHelp rates the interaction as major. Calcium / magnesium / potassium / sodium oxybates and Hydromorphone 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. Oxybates are potent CNS depressants, and with an opioid they can cause profound sedation, respiratory depression, coma and death. The risk rises with dose and in patients with respiratory disease.
How serious is the interaction between Calcium / magnesium / potassium / sodium oxybates and Hydromorphone?
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; if an opioid is unavoidable, use the lowest doses and shortest duration and monitor closely for respiratory depression and sedation. Consider reducing or interrupting the oxybate during opioid treatment.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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