Drug interactions
Hydrocodone + Selegiline
Severity: Major
Hydrocodone and Selegiline: 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
Combining an opioid with a monoamine oxidase inhibitor can cause serotonin syndrome or enhanced opioid toxicity, including respiratory depression and coma. Selegiline loses MAO-B selectivity at higher doses or in transdermal use, which increases the concern.
What this interaction means in plain words
Hydrocodone and Selegiline 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; Selegiline belongs to Central Nervous System.
Why it happens
MAO inhibition may raise central serotonergic activity and impair opioid clearance, producing additive serotonergic and CNS depressant effects.
What to do
Avoid hydrocodone during selegiline therapy and for 14 days after stopping it when possible. If an opioid is unavoidable, use small test doses with careful titration and monitor blood pressure, mental status, and respiration.
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 Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Hydrocodone with Selegiline?
MediHelp rates the interaction as major. Hydrocodone and Selegiline 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. Combining an opioid with a monoamine oxidase inhibitor can cause serotonin syndrome or enhanced opioid toxicity, including respiratory depression and coma. Selegiline loses MAO-B selectivity at higher doses or in transdermal use, which increases the concern.
How serious is the interaction between Hydrocodone and Selegiline?
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 hydrocodone during selegiline therapy and for 14 days after stopping it when possible. If an opioid is unavoidable, use small test doses with careful titration and monitor blood pressure, mental status, and respiration.
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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