Drug interactions
Escitalopram + Hydromorphone
Severity: Moderate
Escitalopram and Hydromorphone: 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
Serotonin syndrome has been reported when opioids are combined with serotonergic antidepressants, although hydromorphone has weak serotonergic activity so the risk is low. Features include agitation, tremor, hyperthermia and neuromuscular hyperactivity.
What this interaction means in plain words
Escitalopram and Hydromorphone 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.
Escitalopram belongs to Central Nervous System; Hydromorphone belongs to Musculoskeletal.
Why it happens
Possible additive serotonergic effect; hydromorphone has little direct serotonin reuptake activity, so the mechanism is largely theoretical.
What to do
The combination can generally be used; monitor for signs of serotonin syndrome, especially at initiation or dose increases. Stop both agents and give supportive care if symptoms develop.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Other interactions of Escitalopram
- Cisapride + Escitalopram Contraindicated
- Citalopram + Escitalopram Contraindicated
- Escitalopram + Isocarboxazid Contraindicated
- Escitalopram + Methylene blue Contraindicated
- Escitalopram + Phenelzine Contraindicated
- Escitalopram + Pimozide Contraindicated
Frequently asked questions
Can I take Escitalopram with Hydromorphone?
MediHelp rates the interaction as moderate. Escitalopram and Hydromorphone 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. Serotonin syndrome has been reported when opioids are combined with serotonergic antidepressants, although hydromorphone has weak serotonergic activity so the risk is low. Features include agitation, tremor, hyperthermia and neuromuscular hyperactivity.
How serious is the interaction between Escitalopram and Hydromorphone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: The combination can generally be used; monitor for signs of serotonin syndrome, especially at initiation or dose increases. Stop both agents and give supportive care if symptoms develop.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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