Drug interactions
Nalbuphine + Oxymorphone
Severity: Major
Nalbuphine and Oxymorphone: 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 partially block mu-opioid effects of oxymorphone. In opioid-dependent patients it may precipitate withdrawal, and it also adds to sedation and respiratory depression.
What this interaction means in plain words
Nalbuphine and Oxymorphone 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; Oxymorphone belongs to Musculoskeletal.
Why it happens
Mu-receptor antagonism or partial agonism by nalbuphine competing with oxymorphone, plus additive CNS depression.
What to do
Avoid combining in opioid-dependent patients. If both are needed, monitor for withdrawal, reduced analgesia and respiratory depression.
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 Oxymorphone
- Alvimopan + Oxymorphone Contraindicated
- Ethanol + Oxymorphone Contraindicated
- Isocarboxazid + Oxymorphone Contraindicated
- Olanzapine / samidorphan + Oxymorphone Contraindicated
- Oxymorphone + Phenelzine Contraindicated
- Oxymorphone + Selegiline transdermal 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 Oxymorphone?
MediHelp rates the interaction as major. Nalbuphine and Oxymorphone 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 partially block mu-opioid effects of oxymorphone. In opioid-dependent patients it may precipitate withdrawal, and it also adds to sedation and respiratory depression.
How serious is the interaction between Nalbuphine and Oxymorphone?
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 combining in opioid-dependent patients. If both are needed, monitor for withdrawal, reduced analgesia and respiratory depression.
What other medicines interact with Oxymorphone?
MediHelp also lists interactions of Oxymorphone with, for example, Alvimopan, Ethanol, Isocarboxazid. The full list is on the Oxymorphone page.
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