Drug interactions
Isoniazid + Meperidine
Severity: Major
Isoniazid and Meperidine: 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
Isoniazid has weak monoamine oxidase inhibiting activity, and meperidine can cause serotonin syndrome with MAO inhibitors. Reports with isoniazid are few, but the potential outcome is serious, and isoniazid may also add to meperidine's CNS effects.
What this interaction means in plain words
Isoniazid and Meperidine 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.
Isoniazid belongs to Anti Bacterial; Meperidine belongs to Musculoskeletal.
Why it happens
Weak MAO inhibition by isoniazid combined with meperidine's serotonin reuptake inhibition may precipitate serotonin toxicity.
What to do
Prefer a non-serotonergic opioid such as morphine in patients on isoniazid. If used together, monitor for agitation, hyperthermia, clonus and autonomic instability.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Other interactions of Isoniazid
Frequently asked questions
Can I take Isoniazid with Meperidine?
MediHelp rates the interaction as major. Isoniazid and Meperidine 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. Isoniazid has weak monoamine oxidase inhibiting activity, and meperidine can cause serotonin syndrome with MAO inhibitors. Reports with isoniazid are few, but the potential outcome is serious, and isoniazid may also add to meperidine's CNS effects.
How serious is the interaction between Isoniazid and Meperidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-serotonergic opioid such as morphine in patients on isoniazid. If used together, monitor for agitation, hyperthermia, clonus and autonomic instability.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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