Notes

Oxycodone And Acetaminophen: Dosage, Mechanism/Onset Of Motion, Half-Life - Medicine.com
Alvimopan: Opioid Agonists might improve the adverse/toxic effect of Alvimopan. That is most notable for patients receiving lengthy-term (i.e., greater than 7 days) opiates prior to alvimopan initiation. Administration: Alvimopan is contraindicated in patients receiving therapeutic doses of opioids for greater than 7 consecutive days immediately previous to alvimopan initiation. Consider therapy modification

Amphetamines: May improve the analgesic effect of Opioid Agonists. Monitor therapy
Anticholinergic Agents: May improve the hostile/toxic impact of Opioid Agonists. Particularly, the chance for constipation and urinary retention may be elevated with this mixture. Monitor therapy

Aprepitant: Might increase the serum concentration of CYP3A4 Substrates (Excessive risk with Inhibitors). Monitor therapy

Azelastine (Nasal): CNS Depressants might enhance the CNS depressant effect of Azelastine (Nasal). Avoid combination

Blonanserin: CNS Depressants may enhance the CNS depressant effect of Blonanserin. Consider therapy modification

Bosentan: Could lower the serum focus of CYP3A4 Substrates (High risk with Inducers). Monitor therapy

Brimonidine (Topical): Might enhance the CNS depressant effect of CNS Depressants. Monitor therapy
Bromopride: Might enhance the CNS depressant effect of CNS Depressants. Monitor therapy

Bromperidol: May enhance the CNS depressant impact of CNS Depressants. Keep away from mixture
Busulfan: Acetaminophen could increase the serum focus of Busulfan. Monitor therapy

Cannabidiol: May enhance the CNS depressant impact of CNS Depressants. Monitor therapy
Cannabis: Might improve the CNS depressant effect of CNS Depressants. Monitor therapy

Chlormethiazole: May improve the CNS depressant effect of CNS Depressants. Management: Monitor carefully for evidence of extreme CNS depression. The chlormethiazole labeling states that an appropriately lowered dose should be used if such a combination have to be used. Consider therapy modification

Chlorphenesin Carbamate: Could enhance the hostile/toxic impact of CNS Depressants. Monitor therapy
Clofazimine: Could improve the serum concentration of CYP3A4 Substrates (Excessive risk with Inhibitors). Monitor therapy

CNS Depressants: Might improve the CNS depressant effect of OxyCODONE. Administration: Avoid concomitant use of oxycodone and benzodiazepines or different CNS depressants when potential. These agents should only be combined if different remedy choices are insufficient. If mixed, limit the dosages and duration of each drug. Consider therapy modification

Conivaptan: Might enhance the serum focus of CYP3A4 Substrates (Excessive risk with Inhibitors). Avoid combination

CYP3A4 Inducers (Reasonable): Might decrease the serum focus of CYP3A4 Substrates (Excessive threat with Inducers). Monitor therapy

CYP3A4 Inducers (Sturdy): Might improve the metabolism of CYP3A4 Substrates (Excessive risk with Inducers). Management: Consider another for one of the interacting medication. Some combinations could also be particularly contraindicated. Consult appropriate producer labeling. Consider therapy modification

CYP3A4 Inhibitors (Average): Might enhance the antagonistic/toxic impact of OxyCODONE. CYP3A4 Inhibitors (Reasonable) might increase the serum concentration of OxyCODONE. Yellow Oxycodone 30mg of the lively metabolite Oxymorphone could even be elevated. Monitor therapy

CYP3A4 Inhibitors (Sturdy): May improve the adverse/toxic effect of OxyCODONE. CYP3A4 Inhibitors (Sturdy) may increase the serum focus of OxyCODONE. Serum concentrations of the lively metabolite oxymorphone might even be elevated. Consider therapy modification

Dabrafenib: May lower the serum concentration of CYP3A4 Substrates (Excessive threat with Inducers). Management: Seek alternate options to the CYP3A4 substrate when potential. If concomitant therapy can't be averted, monitor clinical results of the substrate intently (notably therapeutic results). Consider therapy modification

Dapsone (Topical): Could enhance the antagonistic/toxic impact of Methemoglobinemia Related Agents. Monitor therapy

Dasatinib: Acetaminophen might enhance the hepatotoxic effect of Dasatinib. Dasatinib might improve the serum concentration of Acetaminophen. Consider therapy modification

Deferasirox: Could decrease the serum focus of CYP3A4 Substrates (High danger with Inducers). Monitor therapy

Desmopressin: Opioid Agonists could improve the hostile/toxic impact of Desmopressin. Monitor therapy
Dimethindene (Topical): May improve the CNS depressant impact of CNS Depressants. Monitor therapy

Diuretics: Opioid Agonists could enhance the adverse/toxic impact of Diuretics. Opioid Agonists may diminish the therapeutic impact of Diuretics. Monitor therapy

Dronabinol: Might improve the CNS depressant impact of CNS Depressants. Monitor therapy
Droperidol: Could improve the CNS depressant impact of CNS Depressants. Administration: Consider dose reductions of droperidol or of other CNS agents (eg, opioids, barbiturates) with concomitant use. Exceptions to this monograph are mentioned in additional detail in separate drug interaction monographs. Consider therapy modification

Duvelisib: Might increase the serum focus of CYP3A4 Substrates (Excessive risk with Inhibitors). Monitor therapy

Eluxadoline: Opioid Agonists could improve the constipating impact of Eluxadoline. Keep away from mixture
Enzalutamide: Might lower the serum focus of CYP3A4 Substrates (High risk with Inducers). Management: Concurrent use of enzalutamide with CYP3A4 substrates that have a slender therapeutic index must be prevented. Use of enzalutamide and another CYP3A4 substrate ought to be performed with warning and close monitoring. Consider therapy modification

Erdafitinib: Might lower the serum focus of CYP3A4 Substrates (High risk with Inducers). Monitor therapy

Erdafitinib: May enhance the serum focus of CYP3A4 Substrates (Excessive threat with Inhibitors). Monitor therapy

Flucloxacillin: Could enhance the hostile/toxic impact of Acetaminophen. Specifically, the risk for prime anion hole metabolic acidosis could also be increased. Monitor therapy

Flunitrazepam: CNS Depressants might improve the CNS depressant impact of Flunitrazepam. Consider therapy modification

Fosaprepitant: Could improve the serum focus of CYP3A4 Substrates (Excessive danger with Inhibitors). Monitor therapy

Fosnetupitant: Might increase the serum concentration of CYP3A4 Substrates (High threat with Inhibitors). Monitor therapy

Fusidic Acid (Systemic): Could increase the serum concentration of CYP3A4 Substrates (Excessive danger with Inhibitors). Avoid mixture

Gastrointestinal Agents (Prokinetic): Opioid Agonists may diminish the therapeutic effect of Gastrointestinal Brokers (Prokinetic). Monitor therapy

HYDROcodone: CNS Depressants might improve the CNS depressant effect of HYDROcodone. Management: Keep away from concomitant use of hydrocodone and benzodiazepines or different CNS depressants when attainable. These agents ought to solely be combined if alternative treatment options are insufficient. If mixed, restrict the dosages and duration of each drug. Consider therapy modification

Idelalisib: May improve the serum concentration of CYP3A4 Substrates (Excessive danger with Inhibitors). Keep away from mixture

Imatinib: Acetaminophen may enhance the hepatotoxic effect of Imatinib. Monitor therapy
Isoniazid: Could improve the adversarial/toxic effect of Acetaminophen. Monitor therapy

Ivosidenib: Could lower the serum concentration of CYP3A4 Substrates (Excessive risk with Inducers). Monitor therapy

Kava Kava: Could improve the adverse/toxic impact of CNS Depressants. Monitor therapy
Larotrectinib: Could increase the serum focus of CYP3A4 Substrates (Excessive threat with Inhibitors). Monitor therapy

Lemborexant: Might enhance the CNS depressant impact of CNS Depressants. Administration: Dosage changes of lemborexant and of concomitant CNS depressants could also be obligatory when administered collectively because of probably additive CNS depressant effects. Close monitoring for CNS depressant effects is important. Consider therapy modification

Native Anesthetics: Methemoglobinemia Related Brokers could improve the opposed/toxic impact of Local Anesthetics. Specifically, the chance for methemoglobinemia could also be increased. Monitor therapy

Lofexidine: Could enhance the CNS depressant impact of CNS Depressants. Management: Medicine listed as exceptions to this monograph are mentioned in further element in separate drug interaction monographs. Monitor therapy

Lorlatinib: Could lower the serum focus of CYP3A4 Substrates (High danger with Inducers). Administration: Keep away from concurrent use of lorlatinib with any CYP3A4 substrates for which a minimal decrease in serum concentrations of the CYP3A4 substrate may result in therapeutic failure and critical clinical consequences. Consider therapy modification

Magnesium Sulfate: Might enhance the CNS depressant effect of CNS Depressants. Monitor therapy
Methotrimeprazine: CNS Depressants might improve the CNS depressant impact of Methotrimeprazine. Methotrimeprazine might improve the CNS depressant effect of CNS Depressants. Management: Cut back grownup dose of CNS depressant agents by 50% with initiation of concomitant methotrimeprazine therapy. Further CNS depressant dosage changes needs to be initiated solely after clinically efficient methotrimeprazine dose is established. Consider therapy modification

MetyraPONE: May improve the serum focus of Acetaminophen. More importantly, by inhibiting the conjugative metabolism of acetaminophen, metyrapone could shift the metabolism towards the oxidative route that produces a hepatotoxic metabolite. Monitor therapy

MetyroSINE: CNS Depressants may enhance the sedative impact of MetyroSINE. Monitor therapy
MiFEPRIStone: Could improve the serum focus of CYP3A4 Substrates (Excessive danger with Inhibitors). Administration: Decrease doses of CYP3A4 substrates, and monitor for elevated concentrations/toxicity, throughout and 2 weeks following therapy with mifepristone. Avoid cyclosporine, dihydroergotamine, ergotamine, fentanyl, pimozide, quinidine, sirolimus, and tacrolimus. Consider therapy modification

Minocycline (Systemic): Might enhance the CNS depressant effect of CNS Depressants. Monitor therapy
Mipomersen: Acetaminophen could enhance the hepatotoxic effect of Mipomersen. Monitor therapy

Mitotane: May lower the serum concentration of CYP3A4 Substrates (High danger with Inducers). Management: Doses of CYP3A4 substrates might must be adjusted substantially when used in patients being treated with mitotane. Consider therapy modification

Monoamine Oxidase Inhibitors: OxyCODONE may enhance the serotonergic impact of Monoamine Oxidase Inhibitors. This might lead to serotonin syndrome. Keep away from combination

Nabilone: Might enhance the CNS depressant effect of CNS Depressants. Monitor therapy
Nalmefene: May diminish the therapeutic effect of Opioid Agonists. Management: Keep away from the concomitant use of nalmefene and opioid agonists. Discontinue nalmefene 1 week prior to any anticipated use of opioid agonistss. If mixed, bigger doses of opioid agonists will doubtless be required. Consider therapy modification

Naltrexone: Could diminish the therapeutic effect of Opioid Agonists. Administration: Seek therapeutic options to opioids. See full drug interplay monograph for detailed recommendations. Consider therapy modification

Netupitant: Might increase the serum concentration of CYP3A4 Substrates (High threat with Inhibitors). Monitor therapy

Nitric Oxide: Might enhance the antagonistic/toxic impact of Methemoglobinemia Associated Agents. Combos of these agents may increase the probability of great methemoglobinemia. Monitor therapy

Opioids (Mixed Agonist / Antagonist): Could diminish the analgesic impact of Opioid Agonists. Management: Search alternatives to mixed agonist/antagonist opioids in patients receiving pure opioid agonists, and monitor for signs of therapeutic failure/excessive dose requirements (or withdrawal in opioid-dependent patients) if patients receive these combinations. Keep away from mixture

Orphenadrine: CNS Depressants may improve the CNS depressant effect of Orphenadrine. Keep away from mixture

Oxomemazine: Might enhance the CNS depressant effect of CNS Depressants. Keep away from mixture
Palbociclib: Could increase the serum focus of CYP3A4 Substrates (Excessive threat with Inhibitors). Monitor therapy

Paraldehyde: CNS Depressants could improve the CNS depressant effect of Paraldehyde. Keep away from mixture

Pegvisomant: Opioid Agonists may diminish the therapeutic impact of Pegvisomant. Monitor therapy
Perampanel: Might enhance the CNS depressant impact of CNS Depressants. Management: Patients taking perampanel with any other drug that has CNS depressant activities should keep away from complicated and excessive-threat actions, significantly those such as driving that require alertness and coordination, until they've experience utilizing the mix. Consider therapy modification

PHENobarbital: May enhance the CNS depressant effect of OxyCODONE. PHENobarbital may lower the serum concentration of OxyCODONE. Management: Keep away from use of oxycodone and phenobarbital when attainable. Monitor for respiratory depression/sedation. As a result of phenobarbital can be a strong CYP3A4 inducer, monitor for decreased oxycodone efficacy and withdrawal if mixed. Consider therapy modification

Phenylephrine (Systemic): Acetaminophen may improve the serum concentration of Phenylephrine (Systemic). Monitor therapy

Piribedil: CNS Depressants may improve the CNS depressant effect of Piribedil. Monitor therapy
Pramipexole: CNS Depressants could improve the sedative impact of Pramipexole. Monitor therapy

Prilocaine: Methemoglobinemia Related Brokers might improve the hostile/toxic effect of Prilocaine. Combos of these agents may enhance the likelihood of serious methemoglobinemia. Management: Monitor patients for indicators of methemoglobinemia (e.g., hypoxia, cyanosis) when prilocaine is used together with different brokers associated with improvement of methemoglobinemia. Keep away from lidocaine/prilocaine in infants receiving such agents. Monitor therapy

Primidone: Could improve the CNS depressant impact of OxyCODONE. Primidone may lower the serum concentration of OxyCODONE. Administration: Avoid use of oxycodone and primidone when doable. Monitor for respiratory depression/sedation. As a result of primidone is also a robust CYP3A4 inducer, monitor for decreased oxycodone efficacy and withdrawal if mixed. Consider therapy modification

Probenecid: Could increase the serum focus of Acetaminophen. Probenecid can also restrict the formation of at the least one main non-toxic metabolite, presumably growing the potential for formation of the toxic NAPQI metabolite. Consider therapy modification

Ramosetron: Opioid Agonists might improve the constipating effect of Ramosetron. Monitor therapy
RifAMPin: May lower the serum focus of OxyCODONE. Monitor therapy

ROPINIRole: CNS Depressants may enhance the sedative effect of ROPINIRole. Monitor therapy
Rotigotine: CNS Depressants could enhance the sedative impact of Rotigotine. Monitor therapy

Rufinamide: May improve the opposed/toxic effect of CNS Depressants. Particularly, sleepiness and dizziness could also be enhanced. Monitor therapy

Sarilumab: Could lower the serum focus of CYP3A4 Substrates (Excessive risk with Inducers). Monitor therapy

Selective Serotonin Reuptake Inhibitors: CNS Depressants may enhance the hostile/toxic effect of Selective Serotonin Reuptake Inhibitors. Specifically, the danger of psychomotor impairment may be enhanced. Monitor therapy

Serotonergic Agents (Excessive Danger): Opioid Agonists might enhance the serotonergic impact of Serotonergic Agents (High Threat). This could lead to serotonin syndrome. Management: Monitor for indicators and signs of serotonin syndrome/serotonin toxicity (eg, hyperreflexia, clonus, hyperthermia, diaphoresis, tremor, autonomic instability, psychological standing changes) when these brokers are combined. Monitor therapy

Siltuximab: May lower the serum concentration of CYP3A4 Substrates (Excessive danger with Inducers). Monitor therapy

Simeprevir: Might enhance the serum concentration of CYP3A4 Substrates (Excessive threat with Inhibitors). Monitor therapy

Sincalide: Medicine that Have an effect on Gallbladder Operate might diminish the therapeutic impact of Sincalide. Administration: Consider discontinuing medication which will have an effect on gallbladder motility previous to the usage of sincalide to stimulate gallbladder contraction. Consider therapy modification

Sodium Nitrite: Methemoglobinemia Associated Brokers could enhance the opposed/toxic impact of Sodium Nitrite. Combos of these brokers might improve the probability of significant methemoglobinemia. Monitor therapy

Sodium Oxybate: Might enhance the CNS depressant impact of CNS Depressants. Management: Consider alternate options to combined use. When combined use is needed, consider minimizing doses of one or more drugs. Use of sodium oxybate with alcohol or sedative hypnotics is contraindicated. Consider therapy modification

SORAfenib: Acetaminophen may improve the hepatotoxic impact of SORAfenib. SORAfenib might improve the serum concentration of Acetaminophen. Consider therapy modification

St John's Wort: Could lower the serum focus of OxyCODONE. Monitor therapy
Stiripentol: Might increase the serum concentration of CYP3A4 Substrates (Excessive danger with Inhibitors). Administration: Use of stiripentol with CYP3A4 substrates that are thought of to have a slim therapeutic index must be averted because of the increased risk for adversarial effects and toxicity. Any CYP3A4 substrate used with stiripentol requires closer monitoring. Consider therapy modification

Succinylcholine: Could enhance the bradycardic effect of Opioid Agonists. Monitor therapy
Suvorexant: CNS Depressants might improve the CNS depressant effect of Suvorexant. Administration: Dose reduction of suvorexant and/or another CNS depressant may be mandatory. Use of suvorexant with alcohol shouldn't be recommended, and the use of suvorexant with some other drug to treat insomnia isn't really helpful. Consider therapy modification

Tapentadol: May enhance the CNS depressant effect of CNS Depressants. Management: Keep away from concomitant use of tapentadol and benzodiazepines or other CNS depressants when possible. These brokers ought to solely be combined if different treatment choices are insufficient. If combined, restrict the dosages and duration of every drug. Consider therapy modification

Tetrahydrocannabinol: Could improve the CNS depressant effect of CNS Depressants. Monitor therapy
Tetrahydrocannabinol and Cannabidiol: May improve the CNS depressant effect of CNS Depressants. Monitor therapy

Thalidomide: CNS Depressants might improve the CNS depressant effect of Thalidomide. Avoid combination

Tocilizumab: Could lower the serum focus of CYP3A4 Substrates (High risk with Inducers). Monitor therapy

Vitamin Ok Antagonists (eg, warfarin): Acetaminophen might improve the anticoagulant effect of Vitamin Ok Antagonists. This appears most definitely with every day acetaminophen doses exceeding 1.3 or 2 g/day for a number of consecutive days. Monitor therapy

Voriconazole: Could enhance the opposed/toxic effect of OxyCODONE. Voriconazole could enhance the serum concentration of OxyCODONE . Administration: A decreased oxycodone dose may be obligatory with concurrent voriconazole. Elevated frequency and duration of monitoring for oxycodone-associated adverse effects is really helpful. Consider therapy modification

Zolpidem: CNS Depressants might enhance the CNS depressant effect of Zolpidem. Management: Scale back the Intermezzo brand sublingual zolpidem grownup dose to 1.75 mg for males who're additionally receiving different CNS depressants. No such dose change is beneficial for ladies. Keep away from use with different CNS depressants at bedtime; avoid use with alcohol.

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