Drug interactions
Hydroxyzine + Levorphanol
Severity: Major
Hydroxyzine and Levorphanol: 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
Combining an opioid with a sedating antihistamine may deepen sedation and increase the risk of respiratory depression. Impaired psychomotor performance and falls are also more likely.
What this interaction means in plain words
Hydroxyzine and Levorphanol 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 via opioid receptor agonism and H1 antagonism.
What to do
Use the lowest effective doses and monitor for sedation and respiratory depression, especially at initiation and dose increases. Avoid in patients with respiratory compromise or when other CNS depressants are present.
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 Hydroxyzine
- Droperidol + Hydroxyzine Contraindicated
- Hydroxyzine + Pimozide Contraindicated
- Hydroxyzine + Thioridazine Contraindicated
- Hydroxyzine + Vandetanib Contraindicated
- Alfentanil + Hydroxyzine Major
- Amiodarone + Hydroxyzine Major
Frequently asked questions
Can I take Hydroxyzine with Levorphanol?
MediHelp rates the interaction as major. Hydroxyzine and Levorphanol 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. Combining an opioid with a sedating antihistamine may deepen sedation and increase the risk of respiratory depression. Impaired psychomotor performance and falls are also more likely.
How serious is the interaction between Hydroxyzine and Levorphanol?
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 the lowest effective doses and monitor for sedation and respiratory depression, especially at initiation and dose increases. Avoid in patients with respiratory compromise or when other CNS depressants are present.
What other medicines interact with Hydroxyzine?
MediHelp also lists interactions of Hydroxyzine with, for example, Droperidol, Pimozide, Thioridazine. The full list is on the Hydroxyzine page.
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