Drug interactions
Fluoxetine + Hydromorphone
Severity: Moderate
Fluoxetine 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
Fluoxetine may add to opioid-related sedation and carries a small theoretical risk of serotonin syndrome. Hydromorphone is not primarily metabolized by CYP2D6, so a meaningful rise in its levels is not expected.
What this interaction means in plain words
Fluoxetine 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.
Fluoxetine belongs to Central Nervous System; Hydromorphone belongs to Musculoskeletal.
Why it happens
Possible additive serotonergic effects; hydromorphone is glucuronidated rather than CYP2D6-dependent, so the CYP2D6 inhibition is of little relevance.
What to do
No routine dose change is needed; monitor for serotonin toxicity and excess sedation when starting or increasing either drug. Stop the agents and treat supportively if serotonin syndrome occurs.
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 Fluoxetine
- Fluoxetine + Isocarboxazid Contraindicated
- Fluoxetine + Mavacamten Contraindicated
- Fluoxetine + Methylene blue Contraindicated
- Fluoxetine + Phenelzine Contraindicated
- Fluoxetine + Pimozide Contraindicated
- Fluoxetine + Rasagiline Contraindicated
Frequently asked questions
Can I take Fluoxetine with Hydromorphone?
MediHelp rates the interaction as moderate. Fluoxetine 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. Fluoxetine may add to opioid-related sedation and carries a small theoretical risk of serotonin syndrome. Hydromorphone is not primarily metabolized by CYP2D6, so a meaningful rise in its levels is not expected.
How serious is the interaction between Fluoxetine 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: No routine dose change is needed; monitor for serotonin toxicity and excess sedation when starting or increasing either drug. Stop the agents and treat supportively if serotonin syndrome occurs.
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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