Drug interactions
Hydromorphone + Oxymorphone
Severity: Moderate
Hydromorphone and Oxymorphone: 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
Using two potent full mu-opioid agonists together adds analgesic and toxic effects, including sedation, respiratory depression and constipation. Therapeutic duplication increases overdose risk.
What this interaction means in plain words
Hydromorphone and Oxymorphone 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; Oxymorphone belongs to Musculoskeletal.
Why it happens
Additive mu-opioid receptor agonism.
What to do
Avoid concurrent use unless intentionally transitioning; track total daily opioid dose in morphine equivalents and monitor respiratory status. Reduce the dose when switching because cross-tolerance is incomplete.
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 Oxymorphone
- Alvimopan + Oxymorphone Contraindicated
- Ethanol + Oxymorphone Contraindicated
- Isocarboxazid + Oxymorphone Contraindicated
- Olanzapine / samidorphan + Oxymorphone Contraindicated
- Oxymorphone + Phenelzine Contraindicated
- Oxymorphone + Selegiline transdermal Contraindicated
Frequently asked questions
Can I take Hydromorphone with Oxymorphone?
MediHelp rates the interaction as moderate. Hydromorphone and Oxymorphone 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. Using two potent full mu-opioid agonists together adds analgesic and toxic effects, including sedation, respiratory depression and constipation. Therapeutic duplication increases overdose risk.
How serious is the interaction between Hydromorphone and Oxymorphone?
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 concurrent use unless intentionally transitioning; track total daily opioid dose in morphine equivalents and monitor respiratory status. Reduce the dose when switching because cross-tolerance is incomplete.
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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