Drug interactions
Meperidine + Nalbuphine
Severity: Moderate
Meperidine and Nalbuphine: 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
Nalbuphine is a mixed agonist-antagonist that can add to the sedation and respiratory depression of meperidine. In patients physically dependent on full opioid agonists, its antagonist activity at the mu receptor can precipitate withdrawal and reduce analgesia.
What this interaction means in plain words
Meperidine and Nalbuphine 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.
Meperidine belongs to Musculoskeletal; Nalbuphine belongs to Musculoskeletal.
Why it happens
Nalbuphine is a kappa agonist and partial mu antagonist that competes with meperidine at opioid receptors, producing additive CNS depression or displacement-related withdrawal.
What to do
Avoid giving nalbuphine to patients receiving regular meperidine unless the effect is intended. If used, monitor for respiratory depression, sedation and withdrawal symptoms.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Other interactions of Nalbuphine
- Alvimopan + Nalbuphine Contraindicated
- Nalbuphine + Olanzapine / samidorphan Contraindicated
- Alprazolam + Nalbuphine Major
- Amobarbital + Nalbuphine Major
- Benzhydrocodone / acetaminophen + Nalbuphine Major
- Brexanolone + Nalbuphine Major
Frequently asked questions
Can I take Meperidine with Nalbuphine?
MediHelp rates the interaction as moderate. Meperidine and Nalbuphine 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. Nalbuphine is a mixed agonist-antagonist that can add to the sedation and respiratory depression of meperidine. In patients physically dependent on full opioid agonists, its antagonist activity at the mu receptor can precipitate withdrawal and reduce analgesia.
How serious is the interaction between Meperidine and Nalbuphine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid giving nalbuphine to patients receiving regular meperidine unless the effect is intended. If used, monitor for respiratory depression, sedation and withdrawal symptoms.
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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