Drug interactions
Hydromorphone + Phenobarbital
Severity: Major
Hydromorphone and Phenobarbital: 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
Phenobarbital and opioids both depress the CNS and breathing, risking profound sedation, respiratory depression and death. Phenobarbital is also an enzyme inducer that may modestly lower exposure to some opioids.
What this interaction means in plain words
Hydromorphone and Phenobarbital 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.
Why it happens
Additive CNS and respiratory depression through GABA-A potentiation and opioid agonism.
What to do
Use only with close monitoring of sedation and respiratory rate, starting with reduced opioid doses.
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
Frequently asked questions
Can I take Hydromorphone with Phenobarbital?
MediHelp rates the interaction as major. Hydromorphone and Phenobarbital 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. Phenobarbital and opioids both depress the CNS and breathing, risking profound sedation, respiratory depression and death. Phenobarbital is also an enzyme inducer that may modestly lower exposure to some opioids.
How serious is the interaction between Hydromorphone and Phenobarbital?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use only with close monitoring of sedation and respiratory rate, starting with reduced opioid doses.
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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