Drug interactions
Hydromorphone + Sodium oxybate
Severity: Major
Hydromorphone and Sodium oxybate: 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
Sodium oxybate is a potent CNS depressant, and with hydromorphone the combination can cause profound sedation, respiratory depression, coma and death.
What this interaction means in plain words
Hydromorphone and Sodium oxybate 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; Sodium oxybate belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression through GABA-B/GHB receptor activity and mu-opioid agonism.
What to do
Avoid concurrent use where possible; if unavoidable, use the lowest doses for the shortest time and monitor respiratory status and sedation closely. Consider reducing or interrupting oxybate during opioid therapy.
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?
Pro+ members
Unlock the full page
Create an account and start a Pro+ trial to unlock the full management advice for Hydromorphone and Sodium oxybate, the additional notes, the evidence detail and the whole-prescription interaction checker.
- Full clinical management advice
- Additional notes
- Evidence detail
- Interaction checker for a whole prescription
Try Pro+ free for 7 days on the web. No card needed.
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 Sodium oxybate
- Alprazolam + Sodium oxybate Contraindicated
- Amobarbital + Sodium oxybate Contraindicated
- Butorphanol + Sodium oxybate Contraindicated
- Chloral hydrate + Sodium oxybate Contraindicated
- Clonazepam + Sodium oxybate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Hydromorphone with Sodium oxybate?
MediHelp rates the interaction as major. Hydromorphone and Sodium oxybate 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. Sodium oxybate is a potent CNS depressant, and with hydromorphone the combination can cause profound sedation, respiratory depression, coma and death.
How serious is the interaction between Hydromorphone and Sodium oxybate?
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 concurrent use where possible; if unavoidable, use the lowest doses for the shortest time and monitor respiratory status and sedation closely. Consider reducing or interrupting oxybate during opioid therapy.
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.
Full monographs, dosing and an interaction checker in the MediHelp app
Open the complete reference, check multi-drug interactions and use dosing tools in the MediHelp app.
