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Drug interactions

Meperidine + Olanzapine / samidorphan

Severity: Contraindicated

Meperidine and Olanzapine / samidorphan: contraindicated 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

Samidorphan is an opioid antagonist that blocks the effect of meperidine and can precipitate acute withdrawal in opioid-dependent patients. The combination is contraindicated in patients using opioids.

What this interaction means in plain words

Meperidine and Olanzapine / samidorphan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two.

Evidence level: High

Why it happens

Samidorphan is a mu-opioid receptor antagonist that opposes the pharmacologic effects of opioid agonists.

What to do

Do not start olanzapine/samidorphan until the patient has been opioid-free for at least 7 days for short-acting opioids. Choose another antipsychotic if ongoing opioid therapy is needed.

What to ask your pharmacist

  • Is there an alternative to one of these two medicines for me?
  • If both are essential, who is monitoring me and how often?
  • Which symptoms mean I should stop and seek help straight away?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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Frequently asked questions

Can I take Meperidine with Olanzapine / samidorphan?

MediHelp rates the interaction as contraindicated. Meperidine and Olanzapine / samidorphan are not normally used together. Taking them at the same time is expected to cause harm or make one of them unsafe, so a different medicine is usually chosen for one of the two. Samidorphan is an opioid antagonist that blocks the effect of meperidine and can precipitate acute withdrawal in opioid-dependent patients. The combination is contraindicated in patients using opioids.

How serious is the interaction between Meperidine and Olanzapine / samidorphan?

MediHelp rates it contraindicated, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Do not start olanzapine/samidorphan until the patient has been opioid-free for at least 7 days for short-acting opioids. Choose another antipsychotic if ongoing opioid therapy is needed.

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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