Drug interactions
Hydrocodone + Morphine
Severity: Major
Hydrocodone and Morphine: 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
Two opioid agonists together produce additive sedation, respiratory depression and hypotension, and may cause coma or death. There is rarely a reason to use both concurrently.
What this interaction means in plain words
Hydrocodone and Morphine 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; Morphine belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism causing central respiratory and CNS depression.
What to do
Avoid duplicate opioid therapy; if both are required, use the lowest doses for the shortest time and monitor respiratory rate and sedation. Consider naloxone availability.
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 Morphine
- Alvimopan + Morphine Contraindicated
- Isocarboxazid + Morphine Contraindicated
- Morphine + Olanzapine / samidorphan Contraindicated
- Morphine + Phenelzine Contraindicated
- Morphine + Tranylcypromine Contraindicated
- Alfentanil + Morphine Major
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 Morphine?
MediHelp rates the interaction as major. Hydrocodone and Morphine 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. Two opioid agonists together produce additive sedation, respiratory depression and hypotension, and may cause coma or death. There is rarely a reason to use both concurrently.
How serious is the interaction between Hydrocodone and Morphine?
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 duplicate opioid therapy; if both are required, use the lowest doses for the shortest time and monitor respiratory rate and sedation. Consider naloxone availability.
What other medicines interact with Morphine?
MediHelp also lists interactions of Morphine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Morphine page.
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