Drug interactions
Hydromorphone + Selegiline
Severity: Major
Hydromorphone and Selegiline: 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
Selegiline is an MAO-B inhibitor that loses selectivity at higher doses, and opioids given with MAOIs have caused hypotension, CNS depression and rarely serotonergic reactions. Hydromorphone labeling advises against use with MAOIs.
What this interaction means in plain words
Hydromorphone and Selegiline 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; Selegiline belongs to Central Nervous System.
Why it happens
MAO inhibition may potentiate opioid CNS depression and cause autonomic or serotonergic instability; the mechanism is not fully established.
What to do
Avoid if possible; if needed, use a low hydromorphone starting dose and monitor blood pressure, sedation and signs of serotonin syndrome. Do not start hydromorphone within 14 days of stopping selegiline.
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 Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Hydromorphone with Selegiline?
MediHelp rates the interaction as major. Hydromorphone and Selegiline 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. Selegiline is an MAO-B inhibitor that loses selectivity at higher doses, and opioids given with MAOIs have caused hypotension, CNS depression and rarely serotonergic reactions. Hydromorphone labeling advises against use with MAOIs.
How serious is the interaction between Hydromorphone and Selegiline?
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 if possible; if needed, use a low hydromorphone starting dose and monitor blood pressure, sedation and signs of serotonin syndrome. Do not start hydromorphone within 14 days of stopping selegiline.
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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