Drug interactions
Hydromorphone + Paroxetine
Severity: Moderate
Hydromorphone and Paroxetine: 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
Paroxetine may add to sedation and carries a small theoretical risk of serotonin syndrome with opioids. Hydromorphone is not dependent on CYP2D6, so a significant pharmacokinetic effect is not expected.
What this interaction means in plain words
Hydromorphone and Paroxetine 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; Paroxetine belongs to Central Nervous System.
Why it happens
Possible additive serotonergic effects; hydromorphone is mainly glucuronidated so CYP2D6 inhibition has little relevance.
What to do
No empirical dose change is needed; monitor for serotonin toxicity and sedation when starting or titrating either drug.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Hydromorphone with Paroxetine?
MediHelp rates the interaction as moderate. Hydromorphone and Paroxetine 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. Paroxetine may add to sedation and carries a small theoretical risk of serotonin syndrome with opioids. Hydromorphone is not dependent on CYP2D6, so a significant pharmacokinetic effect is not expected.
How serious is the interaction between Hydromorphone and Paroxetine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: No empirical dose change is needed; monitor for serotonin toxicity and sedation when starting or titrating either drug.
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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