Drug interactions
Meperidine + Nefazodone
Severity: Major
Meperidine and Nefazodone: 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
Nefazodone inhibits serotonin reuptake and is also a CYP3A4 inhibitor, which can alter meperidine metabolism toward more normeperidine. The combination may cause serotonin syndrome and neurotoxicity.
What this interaction means in plain words
Meperidine and Nefazodone 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 serotonergic effects, with possible CYP3A4 inhibition altering meperidine metabolism.
What to do
Prefer a non-serotonergic opioid; if combined, monitor for serotonin syndrome and neuroexcitation.
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
Frequently asked questions
Can I take Meperidine with Nefazodone?
MediHelp rates the interaction as major. Meperidine and Nefazodone 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. Nefazodone inhibits serotonin reuptake and is also a CYP3A4 inhibitor, which can alter meperidine metabolism toward more normeperidine. The combination may cause serotonin syndrome and neurotoxicity.
How serious is the interaction between Meperidine and Nefazodone?
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; if combined, monitor for serotonin syndrome and neuroexcitation.
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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