Drug interactions
Nalbuphine + Oxycodone
Severity: Major
Nalbuphine and Oxycodone: 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
Nalbuphine is a mixed agonist-antagonist that can add to opioid sedation, but in opioid-dependent patients it can displace oxycodone and precipitate withdrawal. Analgesia may also be reduced.
What this interaction means in plain words
Nalbuphine and Oxycodone 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.
Nalbuphine belongs to Musculoskeletal; Oxycodone belongs to Musculoskeletal.
Why it happens
Competitive binding at mu-opioid receptors with partial antagonism by nalbuphine.
What to do
Avoid giving nalbuphine to patients physically dependent on oxycodone. If used, monitor for withdrawal, pain control and sedation.
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 Oxycodone
- Alvimopan + Oxycodone Contraindicated
- Calcium / magnesium / potassium / sodium oxybates + Oxycodone Contraindicated
- Isocarboxazid + Oxycodone Contraindicated
- Olanzapine / samidorphan + Oxycodone Contraindicated
- Oxycodone + Phenelzine Contraindicated
- Oxycodone + Sodium oxybate 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 Nalbuphine with Oxycodone?
MediHelp rates the interaction as major. Nalbuphine and Oxycodone 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. Nalbuphine is a mixed agonist-antagonist that can add to opioid sedation, but in opioid-dependent patients it can displace oxycodone and precipitate withdrawal. Analgesia may also be reduced.
How serious is the interaction between Nalbuphine and Oxycodone?
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 giving nalbuphine to patients physically dependent on oxycodone. If used, monitor for withdrawal, pain control and sedation.
What other medicines interact with Oxycodone?
MediHelp also lists interactions of Oxycodone with, for example, Alvimopan, Calcium / magnesium / potassium / sodium oxybates, Isocarboxazid. The full list is on the Oxycodone page.
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