Drug interactions
Hydromorphone + Meperidine
Severity: Major
Hydromorphone and Meperidine: 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
Two opioid agonists together add to sedation, respiratory depression and hypotension. Meperidine also has a neurotoxic metabolite, normeperidine, that can cause seizures, especially in renal impairment.
What this interaction means in plain words
Hydromorphone and Meperidine 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.
Hydromorphone belongs to Musculoskeletal; Meperidine belongs to Musculoskeletal.
Why it happens
Additive opioid receptor-mediated CNS and respiratory depression.
What to do
Avoid concurrent use; if opioid rotation is needed, reduce the dose and monitor sedation and respiration. Prefer hydromorphone alone.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
Other interactions of Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Hydromorphone with Meperidine?
MediHelp rates the interaction as major. Hydromorphone and Meperidine 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. Two opioid agonists together add to sedation, respiratory depression and hypotension. Meperidine also has a neurotoxic metabolite, normeperidine, that can cause seizures, especially in renal impairment.
How serious is the interaction between Hydromorphone and Meperidine?
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 concurrent use; if opioid rotation is needed, reduce the dose and monitor sedation and respiration. Prefer hydromorphone alone.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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