Drug interactions
Carbamazepine + Hydrocodone
Severity: Moderate
Carbamazepine and Hydrocodone: moderate 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
Carbamazepine strongly induces CYP3A4, reducing hydrocodone levels and its analgesic effect. Stopping carbamazepine can cause hydrocodone concentrations to rise, with a risk of fatal respiratory depression.
What this interaction means in plain words
Carbamazepine and Hydrocodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Carbamazepine belongs to Central Nervous System; Hydrocodone belongs to Musculoskeletal.
Why it happens
CYP3A4 induction by carbamazepine accelerates hydrocodone metabolism.
What to do
Monitor pain control and titrate hydrocodone upward if needed. On carbamazepine discontinuation, reduce the hydrocodone dose and monitor for respiratory depression.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Other interactions of Carbamazepine
- Artemether / lumefantrine + Carbamazepine Contraindicated
- Cabotegravir + Carbamazepine Contraindicated
- Carbamazepine + Delamanid Contraindicated
- Carbamazepine + Dienogest / estradiol valerate Contraindicated
- Carbamazepine + Doravirine Contraindicated
- Carbamazepine + Elbasvir / grazoprevir Contraindicated
Frequently asked questions
Can I take Carbamazepine with Hydrocodone?
MediHelp rates the interaction as moderate. Carbamazepine and Hydrocodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Carbamazepine strongly induces CYP3A4, reducing hydrocodone levels and its analgesic effect. Stopping carbamazepine can cause hydrocodone concentrations to rise, with a risk of fatal respiratory depression.
How serious is the interaction between Carbamazepine and Hydrocodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor pain control and titrate hydrocodone upward if needed. On carbamazepine discontinuation, reduce the hydrocodone dose and monitor for 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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