Drug interactions
Hydrocodone + Loxapine
Severity: Major
Hydrocodone and Loxapine: major 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
Loxapine is a sedating antipsychotic, and adding it to an opioid increases drowsiness, hypotension and respiratory depression. Risk is greater in elderly, debilitated or opioid-naive patients and at higher doses.
What this interaction means in plain words
Hydrocodone and Loxapine 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.
Hydrocodone belongs to Musculoskeletal; Loxapine belongs to Central Nervous System.
Why it happens
Additive CNS depressant effects from opioid agonism and antipsychotic antihistaminic, anti-adrenergic and dopaminergic blockade.
What to do
Reserve for patients without adequate alternatives, start with reduced opioid doses and titrate carefully. Monitor sedation, respiratory rate and blood pressure.
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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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 Loxapine
- Alfentanil + Loxapine Major
- Alprazolam + Loxapine Major
- Amisulpride + Loxapine Major
- Amoxapine + Loxapine Major
- Apomorphine + Loxapine Major
- Belladonna and opium + Loxapine Major
Frequently asked questions
Can I take Hydrocodone with Loxapine?
MediHelp rates the interaction as major. Hydrocodone and Loxapine 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. Loxapine is a sedating antipsychotic, and adding it to an opioid increases drowsiness, hypotension and respiratory depression. Risk is greater in elderly, debilitated or opioid-naive patients and at higher doses.
How serious is the interaction between Hydrocodone and Loxapine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve for patients without adequate alternatives, start with reduced opioid doses and titrate carefully. Monitor sedation, respiratory rate and blood pressure.
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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