Drug interactions
Ethotoin + Meperidine
Severity: Moderate
Ethotoin and Meperidine: 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
Hydantoin anticonvulsants may induce hepatic enzymes and reduce meperidine exposure, while raising the level of the neurotoxic metabolite normeperidine. Data specific to ethotoin are limited and the effect is probably extrapolated from phenytoin.
What this interaction means in plain words
Ethotoin and Meperidine 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.
Why it happens
Probable induction of hepatic CYP enzymes, increasing meperidine metabolism to normeperidine.
What to do
Monitor analgesic response and watch for normeperidine toxicity such as tremor or myoclonus. Consider an alternative opioid for longer-term use.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Ethotoin with Meperidine?
MediHelp rates the interaction as moderate. Ethotoin and Meperidine 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. Hydantoin anticonvulsants may induce hepatic enzymes and reduce meperidine exposure, while raising the level of the neurotoxic metabolite normeperidine. Data specific to ethotoin are limited and the effect is probably extrapolated from phenytoin.
How serious is the interaction between Ethotoin and Meperidine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor analgesic response and watch for normeperidine toxicity such as tremor or myoclonus. Consider an alternative opioid for longer-term use.
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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