Drug interactions
Hydromorphone + Pentazocine
Severity: Major
Hydromorphone and Pentazocine: 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
Pentazocine is a mixed agonist-antagonist that may precipitate withdrawal and reduce analgesia in patients dependent on hydromorphone. In other patients it adds to sedation and respiratory depression.
What this interaction means in plain words
Hydromorphone and Pentazocine 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; Pentazocine belongs to Musculoskeletal.
Why it happens
Partial mu-receptor antagonism with kappa agonism by pentazocine competes with full agonist effects and adds CNS depression.
What to do
Avoid combining in opioid-dependent patients; choose a single opioid strategy. If used together, monitor for withdrawal symptoms, pain control and sedation.
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 Pentazocine
- Calcium / magnesium / potassium / sodium oxybates + Pentazocine Contraindicated
- Olanzapine / samidorphan + Pentazocine Contraindicated
- Pentazocine + Phenelzine Contraindicated
- Pentazocine + Tranylcypromine Contraindicated
- Alfentanil + Pentazocine Major
- Alprazolam + Pentazocine Major
Frequently asked questions
Can I take Hydromorphone with Pentazocine?
MediHelp rates the interaction as major. Hydromorphone and Pentazocine 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. Pentazocine is a mixed agonist-antagonist that may precipitate withdrawal and reduce analgesia in patients dependent on hydromorphone. In other patients it adds to sedation and respiratory depression.
How serious is the interaction between Hydromorphone and Pentazocine?
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 combining in opioid-dependent patients; choose a single opioid strategy. If used together, monitor for withdrawal symptoms, pain control and sedation.
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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