Drug interactions
Hydrocodone + Thioridazine
Severity: Major
Hydrocodone and Thioridazine: 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
Opioids with phenothiazine antipsychotics cause additive sedation, respiratory depression, and hypotension. Thioridazine also prolongs the QT interval, and it is a CYP2D6 substrate and inhibitor, which may alter hydrocodone activation.
What this interaction means in plain words
Hydrocodone and Thioridazine 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; Thioridazine belongs to Central Nervous System.
Why it happens
Additive CNS depressant and hypotensive effects, with possible CYP2D6 inhibition by thioridazine reducing hydrocodone conversion to hydromorphone.
What to do
Avoid if possible or use the lowest doses of each drug and monitor sedation, respiration, and blood pressure. Consider an ECG when QT risk factors are present.
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 Thioridazine
- Abiraterone + Thioridazine Contraindicated
- Adagrasib + Thioridazine Contraindicated
- Amiodarone + Thioridazine Contraindicated
- Amisulpride + Thioridazine Contraindicated
- Amitriptyline + Thioridazine Contraindicated
- Amoxapine + Thioridazine Contraindicated
Frequently asked questions
Can I take Hydrocodone with Thioridazine?
MediHelp rates the interaction as major. Hydrocodone and Thioridazine 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. Opioids with phenothiazine antipsychotics cause additive sedation, respiratory depression, and hypotension. Thioridazine also prolongs the QT interval, and it is a CYP2D6 substrate and inhibitor, which may alter hydrocodone activation.
How serious is the interaction between Hydrocodone and Thioridazine?
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 if possible or use the lowest doses of each drug and monitor sedation, respiration, and blood pressure. Consider an ECG when QT risk factors are present.
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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