Drug interactions
Hydrocodone + Paroxetine
Severity: Moderate
Hydrocodone and Paroxetine: moderate 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
Paroxetine strongly inhibits CYP2D6, which may reduce conversion of hydrocodone to hydromorphone and change analgesic effect. Both drugs are serotonergic, so serotonin syndrome is also possible, and sedation may be additive.
What this interaction means in plain words
Hydrocodone and Paroxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Hydrocodone belongs to Musculoskeletal; Paroxetine belongs to Central Nervous System.
Why it happens
CYP2D6 inhibition by paroxetine plus additive serotonergic activity.
What to do
Monitor pain control and for serotonin toxicity and sedation, particularly at initiation or dose changes. Adjust the hydrocodone dose to response or consider a different analgesic.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Hydrocodone with Paroxetine?
MediHelp rates the interaction as moderate. Hydrocodone and Paroxetine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Paroxetine strongly inhibits CYP2D6, which may reduce conversion of hydrocodone to hydromorphone and change analgesic effect. Both drugs are serotonergic, so serotonin syndrome is also possible, and sedation may be additive.
How serious is the interaction between Hydrocodone and Paroxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor pain control and for serotonin toxicity and sedation, particularly at initiation or dose changes. Adjust the hydrocodone dose to response or consider a different analgesic.
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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