Drug interactions
Hydromorphone + Methylenedioxymethamphetamine
Severity: Major
Hydromorphone and Methylenedioxymethamphetamine: 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
MDMA is an illicit serotonergic stimulant, and combining it with opioids can mask or alter sedation and increase the risk of overdose. Cardiovascular strain and hyperthermia from MDMA add to the danger in a person with opioid-related respiratory depression.
What this interaction means in plain words
Hydromorphone and Methylenedioxymethamphetamine 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.
Why it happens
Opposing and unpredictable CNS effects with additive risks from serotonergic and sympathomimetic toxicity; the mechanism is not fully established.
What to do
Advise against combined use and monitor closely for respiratory depression, hyperthermia and serotonin toxicity if exposure occurs.
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
Frequently asked questions
Can I take Hydromorphone with Methylenedioxymethamphetamine?
MediHelp rates the interaction as major. Hydromorphone and Methylenedioxymethamphetamine 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. MDMA is an illicit serotonergic stimulant, and combining it with opioids can mask or alter sedation and increase the risk of overdose. Cardiovascular strain and hyperthermia from MDMA add to the danger in a person with opioid-related respiratory depression.
How serious is the interaction between Hydromorphone and Methylenedioxymethamphetamine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Advise against combined use and monitor closely for respiratory depression, hyperthermia and serotonin toxicity if exposure occurs.
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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