Drug interactions
Meperidine + Paroxetine
Severity: Major
Meperidine and Paroxetine: 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
Paroxetine potentiates serotonergic effects and meperidine adds serotonin reuptake inhibition, raising the risk of serotonin syndrome. Paroxetine is also a strong CYP2D6 inhibitor and may alter opioid handling, and the pairing can worsen CNS toxicity.
What this interaction means in plain words
Meperidine and Paroxetine 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.
Meperidine belongs to Musculoskeletal; Paroxetine belongs to Central Nervous System.
Why it happens
Additive serotonergic effects from SSRI activity and meperidine's reuptake inhibition.
What to do
Avoid the combination and select a non-serotonergic opioid. If used, monitor for agitation, tremor, clonus and hyperthermia and discontinue if serotonin syndrome occurs.
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 Paroxetine
- Isocarboxazid + Paroxetine Contraindicated
- Methylene blue + Paroxetine Contraindicated
- Paroxetine + Phenelzine Contraindicated
- Paroxetine + Pimozide Contraindicated
- Paroxetine + Procarbazine Contraindicated
- Paroxetine + Selegiline Contraindicated
Frequently asked questions
Can I take Meperidine with Paroxetine?
MediHelp rates the interaction as major. Meperidine and Paroxetine 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. Paroxetine potentiates serotonergic effects and meperidine adds serotonin reuptake inhibition, raising the risk of serotonin syndrome. Paroxetine is also a strong CYP2D6 inhibitor and may alter opioid handling, and the pairing can worsen CNS toxicity.
How serious is the interaction between Meperidine and Paroxetine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid the combination and select a non-serotonergic opioid. If used, monitor for agitation, tremor, clonus and hyperthermia and discontinue if serotonin syndrome occurs.
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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