Drug interactions
Indinavir + Oxycodone
Severity: Major
Indinavir and Oxycodone: 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
Indinavir is a strong CYP3A4 inhibitor and can markedly raise oxycodone plasma concentrations. This may cause excessive sedation, respiratory depression and other opioid toxicity, especially when the combination is started or the inhibitor dose is increased.
What this interaction means in plain words
Indinavir and Oxycodone 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
Inhibition of CYP3A4-mediated N-demethylation of oxycodone to noroxycodone reduces its clearance.
What to do
Reduce the oxycodone dose and titrate to effect, monitoring closely for sedation and respiratory depression. If indinavir is stopped, watch for reduced analgesia and reassess the dose.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Indinavir with Oxycodone?
MediHelp rates the interaction as major. Indinavir and Oxycodone 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. Indinavir is a strong CYP3A4 inhibitor and can markedly raise oxycodone plasma concentrations. This may cause excessive sedation, respiratory depression and other opioid toxicity, especially when the combination is started or the inhibitor dose is increased.
How serious is the interaction between Indinavir and Oxycodone?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Reduce the oxycodone dose and titrate to effect, monitoring closely for sedation and respiratory depression. If indinavir is stopped, watch for reduced analgesia and reassess the dose.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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