Drug interactions
Hydrocodone + Meperidine
Severity: Major
Hydrocodone and Meperidine: 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
Concurrent use of two opioids produces additive sedation, respiratory depression, hypotension and risk of coma or death. Meperidine's neurotoxic metabolite and serotonergic activity add further concerns.
What this interaction means in plain words
Hydrocodone and Meperidine 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; Meperidine belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor-mediated CNS and respiratory depression.
What to do
Avoid concurrent use where possible. If necessary, use the lowest effective doses for the shortest time and monitor respiratory rate and sedation.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
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 Hydrocodone with Meperidine?
MediHelp rates the interaction as major. Hydrocodone and Meperidine 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. Concurrent use of two opioids produces additive sedation, respiratory depression, hypotension and risk of coma or death. Meperidine's neurotoxic metabolite and serotonergic activity add further concerns.
How serious is the interaction between Hydrocodone and Meperidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use where possible. If necessary, use the lowest effective doses for the shortest time and monitor respiratory rate and sedation.
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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