Drug interactions
Oxycodone + Promethazine
Severity: Major
Oxycodone and Promethazine: 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
Promethazine increases the sedative and respiratory depressant effects of oxycodone. Profound sedation, hypotension and respiratory depression can result, especially in opioid-naive or elderly patients.
What this interaction means in plain words
Oxycodone and Promethazine 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.
Oxycodone belongs to Musculoskeletal; Promethazine belongs to Respiratory.
Why it happens
Additive CNS and respiratory depression.
What to do
Use reduced starting doses and monitor sedation and respiratory rate. Avoid in patients with respiratory compromise when possible.
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 Promethazine
- Ibutilide + Promethazine Contraindicated
- Pimozide + Promethazine Contraindicated
- Promethazine + Thioridazine Contraindicated
- Alfentanil + Promethazine Major
- Amiodarone + Promethazine Major
- Amisulpride + Promethazine Major
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
Frequently asked questions
Can I take Oxycodone with Promethazine?
MediHelp rates the interaction as major. Oxycodone and Promethazine 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. Promethazine increases the sedative and respiratory depressant effects of oxycodone. Profound sedation, hypotension and respiratory depression can result, especially in opioid-naive or elderly patients.
How serious is the interaction between Oxycodone and Promethazine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use reduced starting doses and monitor sedation and respiratory rate. Avoid in patients with respiratory compromise when possible.
What other medicines interact with Promethazine?
MediHelp also lists interactions of Promethazine with, for example, Ibutilide, Pimozide, Thioridazine. The full list is on the Promethazine page.
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