Drug interactions
Hydrocodone + Orphenadrine
Severity: Major
Hydrocodone and Orphenadrine: 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
Orphenadrine is a centrally acting anticholinergic muscle relaxant that adds to opioid sedation. The combination can cause profound sedation and respiratory depression, along with anticholinergic effects such as confusion and urinary retention.
What this interaction means in plain words
Hydrocodone and Orphenadrine 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.
Why it happens
Additive CNS depression from opioid agonism and orphenadrine's central anticholinergic effects.
What to do
Avoid if alternatives exist; otherwise use the lowest doses for the shortest time and monitor for sedation, respiratory depression and anticholinergic effects.
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
Frequently asked questions
Can I take Hydrocodone with Orphenadrine?
MediHelp rates the interaction as major. Hydrocodone and Orphenadrine 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. Orphenadrine is a centrally acting anticholinergic muscle relaxant that adds to opioid sedation. The combination can cause profound sedation and respiratory depression, along with anticholinergic effects such as confusion and urinary retention.
How serious is the interaction between Hydrocodone and Orphenadrine?
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 if alternatives exist; otherwise use the lowest doses for the shortest time and monitor for sedation, respiratory depression and anticholinergic effects.
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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