Drug interactions
Diamorphine + Oxycodone
Severity: Major
Diamorphine and Oxycodone: 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
Diamorphine (heroin) is a potent opioid agonist, and combining it with oxycodone duplicates opioid effects with additive sedation and respiratory depression. Overdose risk increases substantially.
What this interaction means in plain words
Diamorphine and Oxycodone 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 causing CNS and respiratory depression.
What to do
Avoid concurrent use unless under a deliberate plan such as palliative care; use reduced doses with close monitoring of 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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Diamorphine with Oxycodone?
MediHelp rates the interaction as major. Diamorphine and Oxycodone 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. Diamorphine (heroin) is a potent opioid agonist, and combining it with oxycodone duplicates opioid effects with additive sedation and respiratory depression. Overdose risk increases substantially.
How serious is the interaction between Diamorphine and Oxycodone?
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 unless under a deliberate plan such as palliative care; use reduced doses with close monitoring of respiratory rate and sedation, and have naloxone available.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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