Drug interactions
Hydrocodone + Olanzapine / samidorphan
Severity: Contraindicated
Hydrocodone and Olanzapine / samidorphan: contraindicated 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
Samidorphan blocks opioid receptors, reducing hydrocodone analgesia and potentially precipitating withdrawal in opioid-dependent patients. Escalating opioid doses to overcome the blockade is dangerous.
What this interaction means in plain words
Hydrocodone and Olanzapine / samidorphan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.
Why it happens
Samidorphan is a mu-opioid receptor antagonist that opposes hydrocodone's agonist effects.
What to do
Ensure at least 7 days opioid-free for short-acting opioids before starting. Use an alternative antipsychotic in patients requiring opioids.
What to ask your pharmacist
- Is there an alternative to one of these two medicines for me?
- If both are essential, who is monitoring me and how often?
- Which symptoms mean I should stop and seek help straight away?
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Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
- Alprazolam + Hydrocodone Major
Frequently asked questions
Can I take Hydrocodone with Olanzapine / samidorphan?
MediHelp rates the interaction as contraindicated. Hydrocodone and Olanzapine / samidorphan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Samidorphan blocks opioid receptors, reducing hydrocodone analgesia and potentially precipitating withdrawal in opioid-dependent patients. Escalating opioid doses to overcome the blockade is dangerous.
How serious is the interaction between Hydrocodone and Olanzapine / samidorphan?
MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Ensure at least 7 days opioid-free for short-acting opioids before starting. Use an alternative antipsychotic in patients requiring opioids.
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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