Drug interactions
Hydrocodone + Perphenazine
Severity: Major
Hydrocodone and Perphenazine: 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
Perphenazine adds sedative and hypotensive effects to opioids, increasing the risk of profound sedation, respiratory depression and hypotension, particularly in volume-depleted or elderly patients.
What this interaction means in plain words
Hydrocodone and Perphenazine 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; Perphenazine belongs to Central Nervous System.
Why it happens
Additive CNS depression and hypotension from opioid agonism and phenothiazine receptor blockade; perphenazine may also inhibit CYP2D6.
What to do
Reserve for patients without alternatives, start with reduced doses and titrate slowly. Monitor sedation, respiratory rate and blood pressure.
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 Perphenazine
- Ibutilide + Perphenazine Contraindicated
- Perphenazine + Pimozide Contraindicated
- Perphenazine + Thioridazine Contraindicated
- Adagrasib + Perphenazine Major
- Alfentanil + Perphenazine Major
- Amiodarone + Perphenazine Major
Frequently asked questions
Can I take Hydrocodone with Perphenazine?
MediHelp rates the interaction as major. Hydrocodone and Perphenazine 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. Perphenazine adds sedative and hypotensive effects to opioids, increasing the risk of profound sedation, respiratory depression and hypotension, particularly in volume-depleted or elderly patients.
How serious is the interaction between Hydrocodone and Perphenazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reserve for patients without alternatives, start with reduced doses and titrate slowly. Monitor sedation, respiratory rate and blood pressure.
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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