Drug interactions
Dextromethorphan + Iloperidone
Severity: Moderate
Dextromethorphan and Iloperidone: 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
Iloperidone is a CYP2D6 substrate, and dextromethorphan acts as a CYP2D6 substrate and competitor with serotonergic activity. Combined use could theoretically cause serotonergic toxicity or neuroleptic-type reactions. Clinical evidence is limited.
What this interaction means in plain words
Dextromethorphan and Iloperidone 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.
Dextromethorphan belongs to Respiratory; Iloperidone belongs to Central Nervous System.
Why it happens
Additive serotonergic and dopaminergic modulation, with possible competition for CYP2D6 metabolism.
What to do
Monitor for agitation, hyperthermia, rigidity and autonomic instability when starting or adjusting either drug. Discontinue and treat if serotonin syndrome or neuroleptic malignant syndrome is suspected.
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 Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
Other interactions of Iloperidone
- Iloperidone + Thioridazine Contraindicated
- Alfuzosin + Iloperidone Major
- Amiodarone + Iloperidone Major
- Amisulpride + Iloperidone Major
- Amitriptyline + Iloperidone Major
- Anagrelide + Iloperidone Major
Frequently asked questions
Can I take Dextromethorphan with Iloperidone?
MediHelp rates the interaction as moderate. Dextromethorphan and Iloperidone 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. Iloperidone is a CYP2D6 substrate, and dextromethorphan acts as a CYP2D6 substrate and competitor with serotonergic activity. Combined use could theoretically cause serotonergic toxicity or neuroleptic-type reactions. Clinical evidence is limited.
How serious is the interaction between Dextromethorphan and Iloperidone?
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 for agitation, hyperthermia, rigidity and autonomic instability when starting or adjusting either drug. Discontinue and treat if serotonin syndrome or neuroleptic malignant syndrome is suspected.
What other medicines interact with Dextromethorphan?
MediHelp also lists interactions of Dextromethorphan with, for example, Isocarboxazid, Linezolid, Phenelzine. The full list is on the Dextromethorphan page.
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