Drug interactions
Hydrocodone + Letermovir
Severity: Moderate
Hydrocodone and Letermovir: 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
Letermovir can raise hydrocodone exposure by inhibiting its CYP3A4-mediated clearance. Higher opioid levels may cause excess sedation and respiratory depression, particularly after initiation of letermovir.
What this interaction means in plain words
Hydrocodone and Letermovir 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.
Hydrocodone belongs to Musculoskeletal; Letermovir belongs to Anti Virals.
Why it happens
Letermovir is a moderate CYP3A inhibitor that reduces CYP3A4-dependent metabolism of hydrocodone to norhydrocodone.
What to do
Monitor for sedation and respiratory depression when letermovir is started and consider lowering the hydrocodone dose. Re-evaluate the dose when letermovir is stopped.
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
Other interactions of Letermovir
- Ergotamine + Letermovir Contraindicated
- Letermovir + Pimozide Contraindicated
- Apalutamide + Letermovir Major
- Atorvastatin + Letermovir Major
- Carbamazepine + Letermovir Major
- Colchicine + Letermovir Major
Frequently asked questions
Can I take Hydrocodone with Letermovir?
MediHelp rates the interaction as moderate. Hydrocodone and Letermovir 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. Letermovir can raise hydrocodone exposure by inhibiting its CYP3A4-mediated clearance. Higher opioid levels may cause excess sedation and respiratory depression, particularly after initiation of letermovir.
How serious is the interaction between Hydrocodone and Letermovir?
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 for sedation and respiratory depression when letermovir is started and consider lowering the hydrocodone dose. Re-evaluate the dose when letermovir is stopped.
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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