Drug interactions
Diphenoxylate-atropine + Hydromorphone
Severity: Major
Diphenoxylate-atropine 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
Hydromorphone is a strong opioid, and adding diphenoxylate increases sedation, respiratory depression and constipation. Atropine adds anticholinergic effects that may increase risk of ileus and urinary retention.
What this interaction means in plain words
Diphenoxylate-atropine 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.
Diphenoxylate-atropine belongs to Gastrointestinal Tract; Hydromorphone belongs to Musculoskeletal.
Why it happens
Additive opioid-mediated central nervous system and respiratory depression and reduced gut motility.
What to do
Avoid combining unless essential and use the lowest doses, monitoring sedation, respiratory rate and bowel function. Stop the antidiarrheal if abdominal distension occurs.
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 Diphenoxylate-atropine
- Diphenoxylate-atropine + Isocarboxazid Contraindicated
- Diphenoxylate-atropine + Phenelzine Contraindicated
- Diphenoxylate-atropine + Tranylcypromine Contraindicated
- Alfentanil + Diphenoxylate-atropine Major
- Alvimopan + Diphenoxylate-atropine Major
- Amitriptyline + Diphenoxylate-atropine Major
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 Diphenoxylate-atropine with Hydromorphone?
MediHelp rates the interaction as major. Diphenoxylate-atropine 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. Hydromorphone is a strong opioid, and adding diphenoxylate increases sedation, respiratory depression and constipation. Atropine adds anticholinergic effects that may increase risk of ileus and urinary retention.
How serious is the interaction between Diphenoxylate-atropine 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 combining unless essential and use the lowest doses, monitoring sedation, respiratory rate and bowel function. Stop the antidiarrheal if abdominal distension occurs.
What other medicines interact with Diphenoxylate-atropine?
MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.
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