Drug interactions
Grapefruit + Hydrocodone
Severity: Moderate
Grapefruit and Hydrocodone: 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
Grapefruit juice inhibits intestinal CYP3A4 and may modestly raise hydrocodone exposure. This could increase sedation and respiratory depression, particularly with large amounts.
What this interaction means in plain words
Grapefruit and Hydrocodone 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
Inhibition of intestinal CYP3A4 by furanocoumarins reducing first-pass metabolism.
What to do
Advise patients to avoid grapefruit products while taking hydrocodone, and monitor for sedation if intake is unavoidable.
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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Grapefruit with Hydrocodone?
MediHelp rates the interaction as moderate. Grapefruit and Hydrocodone 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. Grapefruit juice inhibits intestinal CYP3A4 and may modestly raise hydrocodone exposure. This could increase sedation and respiratory depression, particularly with large amounts.
How serious is the interaction between Grapefruit and Hydrocodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise patients to avoid grapefruit products while taking hydrocodone, and monitor for sedation if intake is unavoidable.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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