Drug interactions
Dextromoramide + Nalbuphine
Severity: Moderate
Dextromoramide and Nalbuphine: 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
Nalbuphine may antagonize the mu agonist effect of dextromoramide, reducing analgesia and possibly precipitating withdrawal in opioid-dependent patients. Additive sedation and respiratory depression are also possible.
What this interaction means in plain words
Dextromoramide and Nalbuphine 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.
Why it happens
Mixed agonist-antagonist competition at mu receptors plus additive opioid CNS depression.
What to do
Avoid giving them together in dependent patients, and otherwise titrate to effect with monitoring of respiration, sedation and withdrawal.
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 Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine Major
Frequently asked questions
Can I take Dextromoramide with Nalbuphine?
MediHelp rates the interaction as moderate. Dextromoramide and Nalbuphine 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. Nalbuphine may antagonize the mu agonist effect of dextromoramide, reducing analgesia and possibly precipitating withdrawal in opioid-dependent patients. Additive sedation and respiratory depression are also possible.
How serious is the interaction between Dextromoramide and Nalbuphine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid giving them together in dependent patients, and otherwise titrate to effect with monitoring of respiration, sedation and withdrawal.
What other medicines interact with Nalbuphine?
MediHelp also lists interactions of Nalbuphine with, for example, Alvimopan, Olanzapine / samidorphan, Alprazolam. The full list is on the Nalbuphine page.
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