Drug interactions
Hydromorphone + Oxycodone
Severity: Moderate
Hydromorphone and Oxycodone: moderate 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 full mu-opioid agonists together produce additive analgesia and additive adverse effects, including sedation, respiratory depression, constipation and overdose risk. Concurrent use is usually a deliberate rotation or breakthrough strategy but duplicates risk.
What this interaction means in plain words
Hydromorphone and Oxycodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Hydromorphone belongs to Musculoskeletal; Oxycodone belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism.
What to do
Avoid unintended duplication; when overlap is required, calculate total opioid exposure in morphine equivalents and monitor for sedation and respiratory depression. Reduce doses during rotation to account for incomplete cross-tolerance.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Hydromorphone with Oxycodone?
MediHelp rates the interaction as moderate. Hydromorphone and Oxycodone can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Two full mu-opioid agonists together produce additive analgesia and additive adverse effects, including sedation, respiratory depression, constipation and overdose risk. Concurrent use is usually a deliberate rotation or breakthrough strategy but duplicates risk.
How serious is the interaction between Hydromorphone and Oxycodone?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid unintended duplication; when overlap is required, calculate total opioid exposure in morphine equivalents and monitor for sedation and respiratory depression. Reduce doses during rotation to account for incomplete cross-tolerance.
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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