Drug interactions
Dextromoramide + Meperidine
Severity: Major
Dextromoramide and Meperidine: 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
Two opioid agonists together cause additive analgesia, sedation and respiratory depression. Overdose, coma and death can occur, particularly with dextromoramide, which is a potent short-acting opioid.
What this interaction means in plain words
Dextromoramide 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.
Why it happens
Additive mu-opioid receptor agonism.
What to do
Avoid concurrent use of two full opioids unless closely supervised, and use reduced doses. Monitor respiratory rate and sedation and have naloxone available.
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 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 Dextromoramide with Meperidine?
MediHelp rates the interaction as major. Dextromoramide 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. Two opioid agonists together cause additive analgesia, sedation and respiratory depression. Overdose, coma and death can occur, particularly with dextromoramide, which is a potent short-acting opioid.
How serious is the interaction between Dextromoramide 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 concurrent use of two full opioids unless closely supervised, and use reduced doses. Monitor respiratory rate and sedation and have naloxone available.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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