Drug interactions
Dextromoramide + Paliperidone
Severity: Major
Dextromoramide and Paliperidone: 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
Dextromoramide is a potent opioid, and combining it with paliperidone increases sedation, hypotension and respiratory depression. The risk is greatest at higher opioid doses or in frail patients.
What this interaction means in plain words
Dextromoramide and Paliperidone 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 CNS and respiratory depression from opioid agonism and antipsychotic sedation.
What to do
Use the lowest effective doses and monitor sedation, respiratory rate and blood pressure. Avoid other CNS depressants and alcohol.
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 Paliperidone
- Ibutilide + Paliperidone Contraindicated
- Paliperidone + Pimozide Contraindicated
- Paliperidone + Vandetanib Contraindicated
- Adagrasib + Paliperidone Major
- Amiodarone + Paliperidone Major
- Amisulpride + Paliperidone Major
Frequently asked questions
Can I take Dextromoramide with Paliperidone?
MediHelp rates the interaction as major. Dextromoramide and Paliperidone 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. Dextromoramide is a potent opioid, and combining it with paliperidone increases sedation, hypotension and respiratory depression. The risk is greatest at higher opioid doses or in frail patients.
How serious is the interaction between Dextromoramide and Paliperidone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor sedation, respiratory rate and blood pressure. Avoid other CNS depressants and alcohol.
What other medicines interact with Paliperidone?
MediHelp also lists interactions of Paliperidone with, for example, Ibutilide, Pimozide, Vandetanib. The full list is on the Paliperidone page.
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