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Drug interactions

Hydromorphone + Phenelzine

Severity: Contraindicated

Hydromorphone and Phenelzine: contraindicated 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

Opioids given with nonselective MAOIs have caused severe reactions including hypotension, hyperthermia, respiratory depression and coma. Hydromorphone labeling advises against use during or within 14 days of MAOI therapy.

What this interaction means in plain words

Hydromorphone and Phenelzine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Hydromorphone belongs to Musculoskeletal; Phenelzine belongs to Central Nervous System.

Evidence level: Moderate

Why it happens

Irreversible MAO inhibition may potentiate opioid CNS and respiratory depression and cause serotonergic or autonomic instability; the exact mechanism is not fully defined.

What to do

Avoid concurrent use and wait at least 14 days after stopping phenelzine before giving hydromorphone. Select an alternative analgesic if the patient is on an MAOI.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Hydromorphone with Phenelzine?

MediHelp rates the interaction as contraindicated. Hydromorphone and Phenelzine are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Opioids given with nonselective MAOIs have caused severe reactions including hypotension, hyperthermia, respiratory depression and coma. Hydromorphone labeling advises against use during or within 14 days of MAOI therapy.

How serious is the interaction between Hydromorphone and Phenelzine?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use and wait at least 14 days after stopping phenelzine before giving hydromorphone. Select an alternative analgesic if the patient is on an MAOI.

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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