Drug interactions
Escitalopram + Meperidine
Severity: Major
Escitalopram and Meperidine: 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
Escitalopram increases synaptic serotonin, and meperidine adds serotonergic activity, so serotonin syndrome may occur. The risk exists even at therapeutic doses and may be hard to recognize early.
What this interaction means in plain words
Escitalopram and Meperidine 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.
Escitalopram belongs to Central Nervous System; Meperidine belongs to Musculoskeletal.
Why it happens
Additive serotonergic effects from SSRI reuptake inhibition and meperidine's serotonergic activity.
What to do
Use an opioid that lacks serotonergic activity, such as morphine. If combined, monitor for tremor, clonus, agitation and fever.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine 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 Meperidine?
MediHelp rates the interaction as major. Escitalopram and Meperidine 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. Escitalopram increases synaptic serotonin, and meperidine adds serotonergic activity, so serotonin syndrome may occur. The risk exists even at therapeutic doses and may be hard to recognize early.
How serious is the interaction between Escitalopram and Meperidine?
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 an opioid that lacks serotonergic activity, such as morphine. If combined, monitor for tremor, clonus, agitation and fever.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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