Drug interactions
Hydrocodone + Oxycodone
Severity: Major
Hydrocodone and Oxycodone: 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
Using two opioid agonists together duplicates therapy and additively raises the risk of sedation, respiratory depression and overdose. It is generally unnecessary and increases the total opioid burden.
What this interaction means in plain words
Hydrocodone and Oxycodone 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; Oxycodone belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism.
What to do
Avoid concurrent use of two opioids unless deliberately planned, such as rotation or breakthrough dosing under supervision. Calculate total morphine milligram equivalents and monitor for respiratory depression.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Hydrocodone with Oxycodone?
MediHelp rates the interaction as major. Hydrocodone and Oxycodone 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. Using two opioid agonists together duplicates therapy and additively raises the risk of sedation, respiratory depression and overdose. It is generally unnecessary and increases the total opioid burden.
How serious is the interaction between Hydrocodone and Oxycodone?
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 of two opioids unless deliberately planned, such as rotation or breakthrough dosing under supervision. Calculate total morphine milligram equivalents and monitor for respiratory depression.
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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