Drug interactions
Hydromorphone + Trimipramine
Severity: Moderate
Hydromorphone and Trimipramine: moderate 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
Both agents cause sedation, so together they can produce excessive drowsiness, impaired alertness and respiratory depression. Trimipramine's anticholinergic and hypotensive effects may add to opioid constipation, urinary retention and dizziness.
What this interaction means in plain words
Hydromorphone and Trimipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Hydromorphone belongs to Musculoskeletal; Trimipramine belongs to Central Nervous System.
Why it happens
Additive CNS depression from opioid agonism and the sedating, antihistaminic and anticholinergic properties of the tricyclic antidepressant.
What to do
Start with low doses and titrate cautiously, monitoring sedation and respiratory function. Counsel patients about driving and alcohol, and watch for constipation and urinary retention.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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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 Trimipramine
- Disopyramide + Trimipramine Contraindicated
- Dofetilide + Trimipramine Contraindicated
- Ibutilide + Trimipramine Contraindicated
- Isocarboxazid + Trimipramine Contraindicated
- Pentamidine + Trimipramine Contraindicated
- Phenelzine + Trimipramine Contraindicated
Frequently asked questions
Can I take Hydromorphone with Trimipramine?
MediHelp rates the interaction as moderate. Hydromorphone and Trimipramine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both agents cause sedation, so together they can produce excessive drowsiness, impaired alertness and respiratory depression. Trimipramine's anticholinergic and hypotensive effects may add to opioid constipation, urinary retention and dizziness.
How serious is the interaction between Hydromorphone and Trimipramine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and titrate cautiously, monitoring sedation and respiratory function. Counsel patients about driving and alcohol, and watch for constipation and urinary retention.
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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