Drug interactions
Doxepin + Nalbuphine
Severity: Moderate
Doxepin 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
Doxepin is a sedating tricyclic antidepressant with strong antihistaminic activity, and it adds to the CNS depression produced by nalbuphine. This can cause pronounced drowsiness, confusion and respiratory depression, particularly in older patients.
What this interaction means in plain words
Doxepin 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.
Doxepin belongs to Dermatology; Nalbuphine belongs to Musculoskeletal.
Why it happens
Additive CNS depression from H1 antagonism and anticholinergic effects of doxepin plus opioid receptor activity.
What to do
Start with lower doses and monitor sedation and respiratory status. Take extra care in elderly patients.
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
Other interactions of Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Doxepin with Nalbuphine?
MediHelp rates the interaction as moderate. Doxepin 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. Doxepin is a sedating tricyclic antidepressant with strong antihistaminic activity, and it adds to the CNS depression produced by nalbuphine. This can cause pronounced drowsiness, confusion and respiratory depression, particularly in older patients.
How serious is the interaction between Doxepin 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: Start with lower doses and monitor sedation and respiratory status. Take extra care in elderly patients.
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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