Drug interactions
Hydrocodone + Protriptyline
Severity: Moderate
Hydrocodone and Protriptyline: 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
Tricyclic antidepressants add to opioid sedation and have some serotonergic activity, so the combination can cause CNS depression and, rarely, serotonin syndrome. Protriptyline may also inhibit CYP2D6 modestly and its anticholinergic effects can add to opioid constipation and urinary retention.
What this interaction means in plain words
Hydrocodone and Protriptyline 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.
Why it happens
Additive CNS depression and serotonergic effects, with possible CYP2D6 inhibition.
What to do
Monitor for sedation, anticholinergic effects, and serotonin toxicity, using the lowest effective doses.
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
Frequently asked questions
Can I take Hydrocodone with Protriptyline?
MediHelp rates the interaction as moderate. Hydrocodone and Protriptyline 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. Tricyclic antidepressants add to opioid sedation and have some serotonergic activity, so the combination can cause CNS depression and, rarely, serotonin syndrome. Protriptyline may also inhibit CYP2D6 modestly and its anticholinergic effects can add to opioid constipation and urinary retention.
How serious is the interaction between Hydrocodone and Protriptyline?
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 for sedation, anticholinergic effects, and serotonin toxicity, using the lowest effective doses.
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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