Drug interactions
Meperidine + Nevirapine
Severity: Moderate
Meperidine and Nevirapine: 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
Nevirapine induces CYP3A4 and CYP2B6, which may increase conversion of meperidine to normeperidine. This could lessen analgesia while increasing the risk of neurotoxicity such as tremor, myoclonus and seizures.
What this interaction means in plain words
Meperidine and Nevirapine 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; Nevirapine belongs to Anti Virals.
Why it happens
Enzyme induction by nevirapine increases formation of the neurotoxic metabolite normeperidine.
What to do
Monitor analgesic effect and signs of CNS excitation; keep meperidine courses short or use an alternative opioid.
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 Nevirapine
- Elbasvir / grazoprevir + Nevirapine Contraindicated
- Nevirapine + Ranolazine Contraindicated
- Nevirapine + St john's wort Contraindicated
- Abemaciclib + Nevirapine Major
- Acalabrutinib + Nevirapine Major
- Amobarbital + Nevirapine Major
Frequently asked questions
Can I take Meperidine with Nevirapine?
MediHelp rates the interaction as moderate. Meperidine and Nevirapine 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. Nevirapine induces CYP3A4 and CYP2B6, which may increase conversion of meperidine to normeperidine. This could lessen analgesia while increasing the risk of neurotoxicity such as tremor, myoclonus and seizures.
How serious is the interaction between Meperidine and Nevirapine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor analgesic effect and signs of CNS excitation; keep meperidine courses short or use an alternative opioid.
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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