Drug interactions
Chlorpromazine + Dextromoramide
Severity: Major
Chlorpromazine and Dextromoramide: major interaction.
Last updated Sources: UK SmPC
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
Chlorpromazine combined with a potent opioid increases sedation, hypotension and the risk of respiratory depression. Profound sedation, coma or death can occur, particularly at higher doses or in vulnerable patients.
What this interaction means in plain words
Chlorpromazine and Dextromoramide 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 opioid receptor agonism and phenothiazine sedation.
What to do
Use the lowest effective doses with initial dose reduction of one or both drugs, and monitor respiratory rate, sedation level and blood pressure. Avoid in patients with compromised respiration.
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
- Chlorpromazine 100mg Tablets - SmPC sections 4.3/4.5 (class statement: morphine derivatives; "Other CNS depressants: morphine derivatives (analgesics, antitussives and substitution treatments), barbiturates, benzodiazepines, anxiolytics other than benzod") — electronic medicines compendium (UK SmPC)
Other interactions of Chlorpromazine
- Chlorpromazine + Dofetilide Contraindicated
- Chlorpromazine + Dronedarone Contraindicated
- Chlorpromazine + Droperidol Contraindicated
- Chlorpromazine + Ibutilide Contraindicated
- Chlorpromazine + Metrizamide Contraindicated
- Chlorpromazine + Panobinostat Contraindicated
Frequently asked questions
Can I take Chlorpromazine with Dextromoramide?
MediHelp rates the interaction as major. Chlorpromazine and Dextromoramide 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. Chlorpromazine combined with a potent opioid increases sedation, hypotension and the risk of respiratory depression. Profound sedation, coma or death can occur, particularly at higher doses or in vulnerable patients.
How serious is the interaction between Chlorpromazine and Dextromoramide?
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 with initial dose reduction of one or both drugs, and monitor respiratory rate, sedation level and blood pressure. Avoid in patients with compromised respiration.
What other medicines interact with Chlorpromazine?
MediHelp also lists interactions of Chlorpromazine with, for example, Dofetilide, Dronedarone, Droperidol. The full list is on the Chlorpromazine page.
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