Drug interactions
Dextromoramide + Hydromorphone
Severity: Major
Dextromoramide and Hydromorphone: major interaction.
Last updated Sources: US FDA label
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 are strong opioid agonists, so combining them gives additive analgesia but also additive sedation, respiratory depression and hypotension. Duplicate opioid therapy increases overdose risk, especially in opioid-naive or frail patients.
What this interaction means in plain words
Dextromoramide 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 mu-opioid receptor agonism with CNS and respiratory depression.
What to do
Avoid concurrent use of two full opioid agonists unless deliberately rotating; if unavoidable, use the lowest effective doses and monitor sedation and respiratory rate closely.
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 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 Dextromoramide with Hydromorphone?
MediHelp rates the interaction as major. Dextromoramide 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. Both are strong opioid agonists, so combining them gives additive analgesia but also additive sedation, respiratory depression and hypotension. Duplicate opioid therapy increases overdose risk, especially in opioid-naive or frail patients.
How serious is the interaction between Dextromoramide 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 concurrent use of two full opioid agonists unless deliberately rotating; if unavoidable, use the lowest effective doses and monitor sedation and respiratory rate closely.
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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