Drug interactions
Dextromethorphan + Meperidine
Severity: Major
Dextromethorphan and Meperidine: major interaction.
Last updated Sources: Base de donnees publique des medicaments (France)
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
Both drugs have serotonergic activity and combined use may precipitate serotonin syndrome. Meperidine is also associated with serotonin toxicity with other serotonergic agents.
What this interaction means in plain words
Dextromethorphan and Meperidine 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.
Dextromethorphan belongs to Respiratory; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects from serotonin reuptake inhibition by both drugs.
What to do
Avoid the combination and use a non-serotonergic analgesic or antitussive. If used, monitor closely for agitation, clonus, hyperthermia and autonomic instability.
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 Dextromethorphan
- Dextromethorphan + Isocarboxazid Contraindicated
- Dextromethorphan + Linezolid Contraindicated
- Dextromethorphan + Phenelzine Contraindicated
- Dextromethorphan + Rasagiline Contraindicated
- Dextromethorphan + Safinamide Contraindicated
- Dextromethorphan + Selegiline Contraindicated
Other interactions of Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Dextromethorphan with Meperidine?
MediHelp rates the interaction as major. Dextromethorphan and Meperidine 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. Both drugs have serotonergic activity and combined use may precipitate serotonin syndrome. Meperidine is also associated with serotonin toxicity with other serotonergic agents.
How serious is the interaction between Dextromethorphan and Meperidine?
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 and use a non-serotonergic analgesic or antitussive. If used, monitor closely for agitation, clonus, hyperthermia and autonomic instability.
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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