Drug interactions
Hydrocodone + Voriconazole
Severity: Major
Hydrocodone and Voriconazole: 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
Voriconazole strongly inhibits CYP3A4 and can raise hydrocodone concentrations. This increases the risk of heavy sedation and potentially fatal respiratory depression.
What this interaction means in plain words
Hydrocodone and Voriconazole 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; Voriconazole belongs to Anti Fungals.
Why it happens
Strong CYP3A4 inhibition reduces hydrocodone metabolism.
What to do
Avoid the combination if possible, or lower the hydrocodone dose and monitor closely for respiratory depression and sedation. Readjust the dose when voriconazole is stopped.
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 Voriconazole
- Avanafil + Voriconazole Contraindicated
- Butabarbital + Voriconazole Contraindicated
- Carbamazepine + Voriconazole Contraindicated
- Conivaptan + Voriconazole Contraindicated
- Dihydroergotamine intranasal + Voriconazole Contraindicated
- Dihydroergotamine + Voriconazole Contraindicated
Frequently asked questions
Can I take Hydrocodone with Voriconazole?
MediHelp rates the interaction as major. Hydrocodone and Voriconazole 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. Voriconazole strongly inhibits CYP3A4 and can raise hydrocodone concentrations. This increases the risk of heavy sedation and potentially fatal respiratory depression.
How serious is the interaction between Hydrocodone and Voriconazole?
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 the combination if possible, or lower the hydrocodone dose and monitor closely for respiratory depression and sedation. Readjust the dose when voriconazole is stopped.
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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