Dilaudid

Overview

hydromorphone

opioid

• UGT2B7 substrate
• antidiuretic hormone effects
• CNS depression
• decreases gastrointestinal motility
• hyponatremia
• hypotensive effects
• lowers seizure threshold
• opioid agonist
• potentiates neuromuscular blockade
• serotonergic effects
• urinary retention

• consider prescribing an opioid overdose reversal agent, especially with concomitant CNS depressant use
• add MAO inhibitor to Interaction Check if recent (14 days) use

Contraindicated

• naltrexone
Dilaudid (hydromorphone)

+

naltrexone

1 interaction

Contraindicated

hydromorphone + naltrexone

contraindicated; D/C hydromorphone at least 7-10 days before naltrexone start; monitor closely if emergency hydromorphone use: combo may decr. hydromorphone efficacy, precipitate withdrawal in opioid dependent patients (antagonistic effects)

• potassium chloride
Dilaudid (hydromorphone)

+

potassium chloride

1 interaction

Contraindicated

hydromorphone + potassium chloride

contraindicated w/ solid potassium formulations; consider alternative, incl. liquid potassium formulations: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)

• potassium citrate
Dilaudid (hydromorphone)

+

potassium citrate

1 interaction

Contraindicated

hydromorphone + potassium citrate

contraindicated w/ solid potassium formulations; consider alternative, incl. liquid potassium formulations: combo may incr. risk of GI ulcerative, stenotic lesions (GI transit delayed, increased local exposure to high potassium concentration)

• safinamide
Dilaudid (hydromorphone)

+

safinamide

1 interaction

Contraindicated

hydromorphone + safinamide

contraindicated w/in 14 days of safinamide use: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• samidorphan
Dilaudid (hydromorphone)

+

samidorphan

1 interaction

Contraindicated

hydromorphone + samidorphan

contraindicated; D/C hydromorphone at least 7 days before samidorphan start; D/C samidorphan at least 5 days before non-urgent hydromorphone use; D/C samidorphan and monitor closely if emergency hydromorphone use: combo may decr. hydromorphone efficacy, precipitate severe withdrawal in opioid dependent patients (antagonistic effects)

Avoid/Use Alternative

• 5-HTP
Dilaudid (hydromorphone)

+

5-HTP

1 interaction

Avoid/Use Alternative

hydromorphone + 5-HTP

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• aldesleukin
Dilaudid (hydromorphone)

+

aldesleukin

1 interaction

Avoid/Use Alternative

hydromorphone + aldesleukin

avoid combo: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe or life-threatening hypotension (including orthostasis, syncope), seizures (additive effects)

• alfentanil
Dilaudid (hydromorphone)

+

alfentanil

1 interaction

Avoid/Use Alternative

hydromorphone + alfentanil

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• almotriptan
Dilaudid (hydromorphone)

+

almotriptan

1 interaction

Avoid/Use Alternative

hydromorphone + almotriptan

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of serotonin syndrome, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• alprazolam
Dilaudid (hydromorphone)

+

alprazolam

1 interaction

Avoid/Use Alternative

hydromorphone + alprazolam

use alternative or monitor BP, respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• amifampridine
Dilaudid (hydromorphone)

+

amifampridine

1 interaction

Avoid/Use Alternative

hydromorphone + amifampridine

consider alternative: combo may incr. risk of seizures (additive effects)

• amitriptyline
Dilaudid (hydromorphone)

+

amitriptyline

1 interaction

Avoid/Use Alternative

hydromorphone + amitriptyline

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• amoxapine
Dilaudid (hydromorphone)

+

amoxapine

1 interaction

Avoid/Use Alternative

hydromorphone + amoxapine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• amphetamine
Dilaudid (hydromorphone)

+

amphetamine

1 interaction

Avoid/Use Alternative

hydromorphone + amphetamine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration; decr. amphetamine start dose: combo may incr. risk of serotonin syndrome (additive effects)

• black cohosh
Dilaudid (hydromorphone)

+

black cohosh

1 interaction

Avoid/Use Alternative

hydromorphone + black cohosh

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• bromocriptine
Dilaudid (hydromorphone)

+

bromocriptine

1 interaction

Avoid/Use Alternative

hydromorphone + bromocriptine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• buprenorphine
Dilaudid (hydromorphone)

+

buprenorphine

1 interaction

Avoid/Use Alternative

hydromorphone + buprenorphine

use alternative or monitor withdrawal sx, respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydromorphone efficacy, precipitate withdrawal in opioid dependent patients; may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus (antagonistic effects; additive effects)

• buspirone
Dilaudid (hydromorphone)

+

buspirone

1 interaction

Avoid/Use Alternative

hydromorphone + buspirone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• butalbital
Dilaudid (hydromorphone)

+

butalbital

1 interaction

Avoid/Use Alternative

hydromorphone + butalbital

avoid combo: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• butorphanol
Dilaudid (hydromorphone)

+

butorphanol

1 interaction

Avoid/Use Alternative

hydromorphone + butorphanol

use alternative or monitor for withdrawal sx, respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydromorphone efficacy, precipitate withdrawal in opioid dependent patients; may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus (antagonistic effects; additive effects)

• carbamazepine
Dilaudid (hydromorphone)

+

carbamazepine

1 interaction

Avoid/Use Alternative

hydromorphone + carbamazepine

use alternative or monitor BP, respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydromorphone levels, efficacy; may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension (including syncope), serotonin syndrome; may alter seizure control (UGT possibly induced; additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• chlordiazepoxide
Dilaudid (hydromorphone)

+

chlordiazepoxide

1 interaction

Avoid/Use Alternative

hydromorphone + chlordiazepoxide

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• citalopram
Dilaudid (hydromorphone)

+

citalopram

1 interaction

Avoid/Use Alternative

hydromorphone + citalopram

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• clobazam
Dilaudid (hydromorphone)

+

clobazam

1 interaction

Avoid/Use Alternative

hydromorphone + clobazam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• clomipramine
Dilaudid (hydromorphone)

+

clomipramine

1 interaction

Avoid/Use Alternative

hydromorphone + clomipramine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension (including orthostasis), seizures, serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• clonazepam
Dilaudid (hydromorphone)

+

clonazepam

1 interaction

Avoid/Use Alternative

hydromorphone + clonazepam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• clonidine
Dilaudid (hydromorphone)

+

clonidine

1 interaction

Avoid/Use Alternative

hydromorphone + clonidine

if ADHD use, avoid combo; otherwise, monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• clopidogrel
Dilaudid (hydromorphone)

+

clopidogrel

1 interaction

Avoid/Use Alternative

hydromorphone + clopidogrel

consider alternative parenteral antiplatelet agent for acute tx of ACS; otherwise, caution advised: combo may decr. clopidogrel and active metabolite levels, efficacy (absorption of clopidogrel possibly affected by delayed gastric emptying)

• clorazepate
Dilaudid (hydromorphone)

+

clorazepate

1 interaction

Avoid/Use Alternative

hydromorphone + clorazepate

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• clozapine
Dilaudid (hydromorphone)

+

clozapine

1 interaction

Avoid/Use Alternative

hydromorphone + clozapine

use alternative or monitor respiratory rate, BP, HR; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, seizures, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (including life-threatening), urinary retention (additive effects)

• cocaine
Dilaudid (hydromorphone)

+

cocaine

1 interaction

Avoid/Use Alternative

hydromorphone + cocaine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• codeine
Dilaudid (hydromorphone)

+

codeine

1 interaction

Avoid/Use Alternative

hydromorphone + codeine

avoid combo if antitussive use; otherwise use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation/paralytic ileus (additive effects)

• cyclobenzaprine
Dilaudid (hydromorphone)

+

cyclobenzaprine

1 interaction

Avoid/Use Alternative

hydromorphone + cyclobenzaprine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• desipramine
Dilaudid (hydromorphone)

+

desipramine

1 interaction

Avoid/Use Alternative

hydromorphone + desipramine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• desvenlafaxine
Dilaudid (hydromorphone)

+

desvenlafaxine

1 interaction

Avoid/Use Alternative

hydromorphone + desvenlafaxine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• dexmethylphenidate
Dilaudid (hydromorphone)

+

dexmethylphenidate

1 interaction

Avoid/Use Alternative

hydromorphone + dexmethylphenidate

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• dextroamphetamine
Dilaudid (hydromorphone)

+

dextroamphetamine

1 interaction

Avoid/Use Alternative

hydromorphone + dextroamphetamine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration; decr. dextroamphetamine start dose: combo may incr. risk of serotonin syndrome (additive effects)

• dextromethorphan
Dilaudid (hydromorphone)

+

dextromethorphan

1 interaction

Avoid/Use Alternative

hydromorphone + dextromethorphan

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• diazepam
Dilaudid (hydromorphone)

+

diazepam

1 interaction

Avoid/Use Alternative

hydromorphone + diazepam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope); may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• dihydrocodeine
Dilaudid (hydromorphone)

+

dihydrocodeine

1 interaction

Avoid/Use Alternative

hydromorphone + dihydrocodeine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• dihydroergotamine
Dilaudid (hydromorphone)

+

dihydroergotamine

1 interaction

Avoid/Use Alternative

hydromorphone + dihydroergotamine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• doxepin
Dilaudid (hydromorphone)

+

doxepin

1 interaction

Avoid/Use Alternative

hydromorphone + doxepin

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• doxepin topical
Dilaudid (hydromorphone)

+

doxepin topical

1 interaction

Avoid/Use Alternative

hydromorphone + doxepin topical

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• doxylamine
Dilaudid (hydromorphone)

+

doxylamine

1 interaction

Avoid/Use Alternative

hydromorphone + doxylamine

avoid combo if doxylamine use for pregnancy-related nausea/vomiting, otherwise, monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• duloxetine
Dilaudid (hydromorphone)

+

duloxetine

1 interaction

Avoid/Use Alternative

hydromorphone + duloxetine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• eletriptan
Dilaudid (hydromorphone)

+

eletriptan

1 interaction

Avoid/Use Alternative

hydromorphone + eletriptan

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• eluxadoline
Dilaudid (hydromorphone)

+

eluxadoline

1 interaction

Avoid/Use Alternative

hydromorphone + eluxadoline

avoid combo: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• ergotamine
Dilaudid (hydromorphone)

+

ergotamine

1 interaction

Avoid/Use Alternative

hydromorphone + ergotamine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• escitalopram
Dilaudid (hydromorphone)

+

escitalopram

1 interaction

Avoid/Use Alternative

hydromorphone + escitalopram

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• esketamine
Dilaudid (hydromorphone)

+

esketamine

1 interaction

Avoid/Use Alternative

hydromorphone + esketamine

use alternative or monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• estazolam
Dilaudid (hydromorphone)

+

estazolam

1 interaction

Avoid/Use Alternative

hydromorphone + estazolam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• ethanol (alcoholic beverage)
Dilaudid (hydromorphone)

+

ethanol (alcoholic beverage)

1 interaction

Avoid/Use Alternative

hydromorphone + ethanol (alcoholic beverage)

avoid combo: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• ethanol injection
Dilaudid (hydromorphone)

+

ethanol injection

1 interaction

Avoid/Use Alternative

hydromorphone + ethanol injection

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant use: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• etomidate
Dilaudid (hydromorphone)

+

etomidate

1 interaction

Avoid/Use Alternative

hydromorphone + etomidate

use alternative or monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension (additive effects)

• fenfluramine
Dilaudid (hydromorphone)

+

fenfluramine

1 interaction

Avoid/Use Alternative

hydromorphone + fenfluramine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• fentanyl
Dilaudid (hydromorphone)

+

fentanyl

1 interaction

Avoid/Use Alternative

hydromorphone + fentanyl

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• fluoxetine
Dilaudid (hydromorphone)

+

fluoxetine

1 interaction

Avoid/Use Alternative

hydromorphone + fluoxetine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• flurazepam
Dilaudid (hydromorphone)

+

flurazepam

1 interaction

Avoid/Use Alternative

hydromorphone + flurazepam

use alternative or monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• fluvoxamine
Dilaudid (hydromorphone)

+

fluvoxamine

1 interaction

Avoid/Use Alternative

hydromorphone + fluvoxamine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• frovatriptan
Dilaudid (hydromorphone)

+

frovatriptan

1 interaction

Avoid/Use Alternative

hydromorphone + frovatriptan

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• gabapentin
Dilaudid (hydromorphone)

+

gabapentin

1 interaction

Avoid/Use Alternative

hydromorphone + gabapentin

use alternative or monitor respiratory rate; decrease dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decrease seizure threshold)

• gabapentin enacarbil
Dilaudid (hydromorphone)

+

gabapentin enacarbil

1 interaction

Avoid/Use Alternative

hydromorphone + gabapentin enacarbil

use alternative or monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• gepirone
Dilaudid (hydromorphone)

+

gepirone

1 interaction

Avoid/Use Alternative

hydromorphone + gepirone

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• granisetron
Dilaudid (hydromorphone)

+

granisetron

1 interaction

Avoid/Use Alternative

hydromorphone + granisetron

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• haloperidol
Dilaudid (hydromorphone)

+

haloperidol

1 interaction

Avoid/Use Alternative

hydromorphone + haloperidol

avoid combo: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• hydrocodone
Dilaudid (hydromorphone)

+

hydrocodone

1 interaction

Avoid/Use Alternative

hydromorphone + hydrocodone

avoid combo if antitussive use; otherwise use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• hydromorphone
Dilaudid (hydromorphone)

+

hydromorphone

1 interaction

Avoid/Use Alternative

hydromorphone + hydromorphone

avoid combo: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, other adverse effects (additive effects, duplicate therapy)

• imipramine
Dilaudid (hydromorphone)

+

imipramine

1 interaction

Avoid/Use Alternative

hydromorphone + imipramine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• iohexol
Dilaudid (hydromorphone)

+

iohexol

1 interaction

Avoid/Use Alternative

hydromorphone + iohexol

avoid combo if intrathecal iohexol use: combo may incr. risk of seizures (additive effects)

• isocarboxazid
Dilaudid (hydromorphone)

+

isocarboxazid

1 interaction

Avoid/Use Alternative

hydromorphone + isocarboxazid

use alternative or monitor respiratory rate, BP, serotonin syndrome sx w/in 14 days of isocarboxazid use, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• isoniazid
Dilaudid (hydromorphone)

+

isoniazid

1 interaction

Avoid/Use Alternative

hydromorphone + isoniazid

use alternative or monitor respiratory rate, serotonin syndrome sx w/in 14 days of isoniazid use, especially during initiation/titration: combo may incr. risk of respiratory depression, serotonin syndrome (additive effects, isoniazid inhibits monoamine oxidase)

• kava
Dilaudid (hydromorphone)

+

kava

1 interaction

Avoid/Use Alternative

hydromorphone + kava

avoid combo: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• ketamine
Dilaudid (hydromorphone)

+

ketamine

1 interaction

Avoid/Use Alternative

hydromorphone + ketamine

use alternative or monitor respiratory rate; decr. dose of one or both drugs; use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression (including life-threatening), psychomotor impairment, delayed recovery from anesthesia (additive effects)

• kratom
Dilaudid (hydromorphone)

+

kratom

1 interaction

Avoid/Use Alternative

hydromorphone + kratom

use alternative or monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• levomilnacipran
Dilaudid (hydromorphone)

+

levomilnacipran

1 interaction

Avoid/Use Alternative

hydromorphone + levomilnacipran

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• levorphanol
Dilaudid (hydromorphone)

+

levorphanol

1 interaction

Avoid/Use Alternative

hydromorphone + levorphanol

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. levorphanol start dose by at least 50%, consider decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• linezolid
Dilaudid (hydromorphone)

+

linezolid

1 interaction

Avoid/Use Alternative

hydromorphone + linezolid

use alternative or hold hydromorphone if urgent use; monitor respiratory rate, serotonin syndrome sx x2wk after hydromorphone D/C or 24h after last linezolid dose: combo may incr. risk of respiratory depression, serotonin syndrome (additive effects, linezolid reversibly inhibits monoamine oxidase)

• lisdexamfetamine
Dilaudid (hydromorphone)

+

lisdexamfetamine

1 interaction

Avoid/Use Alternative

hydromorphone + lisdexamfetamine

use alternative or decr. lisdexamfetamine start dose; monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• lithium
Dilaudid (hydromorphone)

+

lithium

1 interaction

Avoid/Use Alternative

hydromorphone + lithium

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• lofexidine
Dilaudid (hydromorphone)

+

lofexidine

1 interaction

Avoid/Use Alternative

hydromorphone + lofexidine

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• lorazepam
Dilaudid (hydromorphone)

+

lorazepam

1 interaction

Avoid/Use Alternative

hydromorphone + lorazepam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• lumateperone
Dilaudid (hydromorphone)

+

lumateperone

1 interaction

Avoid/Use Alternative

hydromorphone + lumateperone

use alternative or monitor BP, respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome (additive effects)

• meperidine
Dilaudid (hydromorphone)

+

meperidine

1 interaction

Avoid/Use Alternative

hydromorphone + meperidine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. meperidine dose 25-50%, consider decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• metaxalone
Dilaudid (hydromorphone)

+

metaxalone

1 interaction

Avoid/Use Alternative

hydromorphone + metaxalone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• methadone
Dilaudid (hydromorphone)

+

methadone

1 interaction

Avoid/Use Alternative

hydromorphone + methadone

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation/paralytic ileus (additive effects)

• methamphetamine
Dilaudid (hydromorphone)

+

methamphetamine

1 interaction

Avoid/Use Alternative

hydromorphone + methamphetamine

use alternative or decr. methamphetamine start dose; monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• methylene blue injection
Dilaudid (hydromorphone)

+

methylene blue injection

1 interaction

Avoid/Use Alternative

hydromorphone + methylene blue injection

use alternative or hold hydromorphone if emergency use; monitor respiratory rate, BP, serotonin syndrome sx up to 4h after last methylene blue dose; may resume hydromorphone 72h after last methylene blue dose: combo may incr. risk of respiratory depression, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects, methylene blue reversibly inhibits monoamine oxidase)

• methylene blue oral
Dilaudid (hydromorphone)

+

methylene blue oral

1 interaction

Avoid/Use Alternative

hydromorphone + methylene blue oral

use alternative or monitor respiratory rate, serotonin syndrome sx w/in 14 days of methylene blue use, especially during initiation/titration: combo may incr. risk of respiratory depression, serotonin syndrome (additive effects, methylene blue reversibly inhibits monoamine oxidase)

• methylergonovine
Dilaudid (hydromorphone)

+

methylergonovine

1 interaction

Avoid/Use Alternative

hydromorphone + methylergonovine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• methylphenidate
Dilaudid (hydromorphone)

+

methylphenidate

1 interaction

Avoid/Use Alternative

hydromorphone + methylphenidate

use alternative or monitor serotonin syndrome symptoms, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• metoclopramide
Dilaudid (hydromorphone)

+

metoclopramide

1 interaction

Avoid/Use Alternative

hydromorphone + metoclopramide

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome; may decr. metoclopramide efficacy (additive effects; antagonistic effects; absorption of oral metoclopramide affected by delayed gastric emptying)

• midazolam
Dilaudid (hydromorphone)

+

midazolam

1 interaction

Avoid/Use Alternative

hydromorphone + midazolam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• milnacipran
Dilaudid (hydromorphone)

+

milnacipran

1 interaction

Avoid/Use Alternative

hydromorphone + milnacipran

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• mirtazapine
Dilaudid (hydromorphone)

+

mirtazapine

1 interaction

Avoid/Use Alternative

hydromorphone + mirtazapine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• morphine
Dilaudid (hydromorphone)

+

morphine

1 interaction

Avoid/Use Alternative

hydromorphone + morphine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• nalbuphine
Dilaudid (hydromorphone)

+

nalbuphine

1 interaction

Avoid/Use Alternative

hydromorphone + nalbuphine

use alternative or monitor for withdrawal sx, respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydromorphone efficacy, precipitate withdrawal in opioid dependent patients; may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus (antagonistic effects; additive effects)

• naratriptan
Dilaudid (hydromorphone)

+

naratriptan

1 interaction

Avoid/Use Alternative

hydromorphone + naratriptan

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• nefazodone
Dilaudid (hydromorphone)

+

nefazodone

1 interaction

Avoid/Use Alternative

hydromorphone + nefazodone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• nortriptyline
Dilaudid (hydromorphone)

+

nortriptyline

1 interaction

Avoid/Use Alternative

hydromorphone + nortriptyline

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• olanzapine
Dilaudid (hydromorphone)

+

olanzapine

1 interaction

Avoid/Use Alternative

hydromorphone + olanzapine

consider alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (including life-threatening), urinary retention (additive effects)

• oliceridine
Dilaudid (hydromorphone)

+

oliceridine

1 interaction

Avoid/Use Alternative

hydromorphone + oliceridine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus (additive effects)

• ondansetron
Dilaudid (hydromorphone)

+

ondansetron

1 interaction

Avoid/Use Alternative

hydromorphone + ondansetron

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• opium
Dilaudid (hydromorphone)

+

opium

1 interaction

Avoid/Use Alternative

hydromorphone + opium

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• oxazepam
Dilaudid (hydromorphone)

+

oxazepam

1 interaction

Avoid/Use Alternative

hydromorphone + oxazepam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• oxybate
Dilaudid (hydromorphone)

+

oxybate

1 interaction

Avoid/Use Alternative

hydromorphone + oxybate

use alternative or monitor respiratory rate; consider holding oxybate, especially if peri- or post-operative opioid analgesia required: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, hypotension, syncope (additive effects)

• oxycodone
Dilaudid (hydromorphone)

+

oxycodone

1 interaction

Avoid/Use Alternative

hydromorphone + oxycodone

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. oxycodone start dose by at least 50%, consider decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation/paralytic ileus (additive effects)

• oxymorphone
Dilaudid (hydromorphone)

+

oxymorphone

1 interaction

Avoid/Use Alternative

hydromorphone + oxymorphone

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. oxymorphone start dose by at least 50%, consider decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• palonosetron
Dilaudid (hydromorphone)

+

palonosetron

1 interaction

Avoid/Use Alternative

hydromorphone + palonosetron

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• paroxetine
Dilaudid (hydromorphone)

+

paroxetine

1 interaction

Avoid/Use Alternative

hydromorphone + paroxetine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• pentazocine
Dilaudid (hydromorphone)

+

pentazocine

1 interaction

Avoid/Use Alternative

hydromorphone + pentazocine

use alternative or monitor for withdrawal sx, respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydromorphone efficacy, precipitate withdrawal in opioid dependent patients; may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus (antagonistic effects; additive effects)

• phenelzine
Dilaudid (hydromorphone)

+

phenelzine

1 interaction

Avoid/Use Alternative

hydromorphone + phenelzine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx w/in 14 days of phenelzine use, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• phenobarbital
Dilaudid (hydromorphone)

+

phenobarbital

1 interaction

Avoid/Use Alternative

hydromorphone + phenobarbital

use alternative or monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• pramlintide
Dilaudid (hydromorphone)

+

pramlintide

1 interaction

Avoid/Use Alternative

hydromorphone + pramlintide

consider alternative: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• prasugrel
Dilaudid (hydromorphone)

+

prasugrel

1 interaction

Avoid/Use Alternative

hydromorphone + prasugrel

consider alternative parenteral antiplatelet agent for acute tx of ACS; otherwise, caution advised: combo may decr. prasugrel active metabolite levels, efficacy (absorption of prasugrel possibly affected by delayed gastric emptying)

• pregabalin
Dilaudid (hydromorphone)

+

pregabalin

1 interaction

Avoid/Use Alternative

hydromorphone + pregabalin

use alternative or monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• procarbazine
Dilaudid (hydromorphone)

+

procarbazine

1 interaction

Avoid/Use Alternative

hydromorphone + procarbazine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx w/in 14 days of procarbazine use, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects, procarbazine inhibits monoamine oxidase)

• prochlorperazine
Dilaudid (hydromorphone)

+

prochlorperazine

1 interaction

Avoid/Use Alternative

hydromorphone + prochlorperazine

consider alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• promethazine
Dilaudid (hydromorphone)

+

promethazine

1 interaction

Avoid/Use Alternative

hydromorphone + promethazine

use alternative or monitor respiratory rate, BP; decr. hydromorphone dose by at least 25-50%, consider decr. promethazine dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, seizures, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• protriptyline
Dilaudid (hydromorphone)

+

protriptyline

1 interaction

Avoid/Use Alternative

hydromorphone + protriptyline

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• quazepam
Dilaudid (hydromorphone)

+

quazepam

1 interaction

Avoid/Use Alternative

hydromorphone + quazepam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• rasagiline
Dilaudid (hydromorphone)

+

rasagiline

1 interaction

Avoid/Use Alternative

hydromorphone + rasagiline

use alternative or monitor respiratory rate, BP, serotonin syndrome sx w/in 14 days of rasagiline use, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• remimazolam
Dilaudid (hydromorphone)

+

remimazolam

1 interaction

Avoid/Use Alternative

hydromorphone + remimazolam

use alternative or monitor BP, respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of severe hypotension (including orthostasis, syncope), profound CNS and respiratory depression, psychomotor impairment (additive effects)

• revefenacin inhaled
Dilaudid (hydromorphone)

+

revefenacin inhaled

1 interaction

Avoid/Use Alternative

hydromorphone + revefenacin inhaled

consider alternative: combo may incr. risk of severe constipation, paralytic ileus (additive effects)

• rizatriptan
Dilaudid (hydromorphone)

+

rizatriptan

1 interaction

Avoid/Use Alternative

hydromorphone + rizatriptan

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• ropeginterferon alfa-2b
Dilaudid (hydromorphone)

+

ropeginterferon alfa-2b

1 interaction

Avoid/Use Alternative

hydromorphone + ropeginterferon alfa-2b

use alternative or monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• SAMe
Dilaudid (hydromorphone)

+

SAMe

1 interaction

Avoid/Use Alternative

hydromorphone + SAMe

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• scopolamine
Dilaudid (hydromorphone)

+

scopolamine

1 interaction

Avoid/Use Alternative

hydromorphone + scopolamine

use alternative or monitor respiratory rate; decrease dose of one or both drugs, use lowest effective doses and shortest duration of concomitant treatment: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• selegiline
Dilaudid (hydromorphone)

+

selegiline

1 interaction

Avoid/Use Alternative

hydromorphone + selegiline

use alternative or monitor respiratory rate, BP, serotonin syndrome sx w/in 14 days of selegiline use, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• selegiline transdermal
Dilaudid (hydromorphone)

+

selegiline transdermal

1 interaction

Avoid/Use Alternative

hydromorphone + selegiline transdermal

use alternative or monitor respiratory rate, BP, serotonin syndrome sx w/in 14 days of selegiline use, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• sertraline
Dilaudid (hydromorphone)

+

sertraline

1 interaction

Avoid/Use Alternative

hydromorphone + sertraline

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• St. John's wort
Dilaudid (hydromorphone)

+

St. John's wort

1 interaction

Avoid/Use Alternative

hydromorphone + St. John's wort

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• sumatriptan
Dilaudid (hydromorphone)

+

sumatriptan

1 interaction

Avoid/Use Alternative

hydromorphone + sumatriptan

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• tapentadol
Dilaudid (hydromorphone)

+

tapentadol

1 interaction

Avoid/Use Alternative

hydromorphone + tapentadol

use alternative or monitor respiratory rate, BP, serotonin syndrome symptoms, especially during initiation/titration; decrease dose of one or both drugs, use lowest effective doses and shortest duration of concomitant treatment: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus (additive effects)

• tedizolid
Dilaudid (hydromorphone)

+

tedizolid

1 interaction

Avoid/Use Alternative

hydromorphone + tedizolid

use alternative or monitor resp. rate, serotonin syndrome sx w/in 14 days of tedizolid use, especially during initiation/titration: combo may incr. risk of respiratory depression, serotonin syndrome (additive effects, tedizolid reversibly inhibits monoamine oxidase)

• temazepam
Dilaudid (hydromorphone)

+

temazepam

1 interaction

Avoid/Use Alternative

hydromorphone + temazepam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• thalidomide
Dilaudid (hydromorphone)

+

thalidomide

1 interaction

Avoid/Use Alternative

hydromorphone + thalidomide

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• ticagrelor
Dilaudid (hydromorphone)

+

ticagrelor

1 interaction

Avoid/Use Alternative

hydromorphone + ticagrelor

consider alternative parenteral antiplatelet agent for acute tx of ACS; otherwise, caution advised: combo may decr. ticagrelor and active metabolite levels, efficacy (absorption of ticagrelor possibly affected by delayed gastric emptying)

• tradipitant
Dilaudid (hydromorphone)

+

tradipitant

1 interaction

Avoid/Use Alternative

hydromorphone + tradipitant

use alternative or monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• tramadol
Dilaudid (hydromorphone)

+

tramadol

1 interaction

Avoid/Use Alternative

hydromorphone + tramadol

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), seizures, serotonin syndrome, severe constipation, paralytic ileus (additive effects)

• tranylcypromine
Dilaudid (hydromorphone)

+

tranylcypromine

1 interaction

Avoid/Use Alternative

hydromorphone + tranylcypromine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx w/in 14 days of tranylcypromine use, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• trazodone
Dilaudid (hydromorphone)

+

trazodone

1 interaction

Avoid/Use Alternative

hydromorphone + trazodone

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects)

• triazolam
Dilaudid (hydromorphone)

+

triazolam

1 interaction

Avoid/Use Alternative

hydromorphone + triazolam

use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• trimipramine
Dilaudid (hydromorphone)

+

trimipramine

1 interaction

Avoid/Use Alternative

hydromorphone + trimipramine

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), serotonin syndrome, severe constipation, paralytic ileus, urinary retention (additive effects)

• venlafaxine
Dilaudid (hydromorphone)

+

venlafaxine

1 interaction

Avoid/Use Alternative

hydromorphone + venlafaxine

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• vilazodone
Dilaudid (hydromorphone)

+

vilazodone

1 interaction

Avoid/Use Alternative

hydromorphone + vilazodone

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• vortioxetine
Dilaudid (hydromorphone)

+

vortioxetine

1 interaction

Avoid/Use Alternative

hydromorphone + vortioxetine

use alternative or monitor serotonin syndrome sx, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

• yohimbe
Dilaudid (hydromorphone)

+

yohimbe

1 interaction

Avoid/Use Alternative

hydromorphone + yohimbe

use alternative or monitor respiratory rate, BP, especially w/ high yohimbe doses, serotonin syndrome sx w/in 14 days of yohimbe use, especially during initiation/titration: combo may incr. risk of respiratory depression, serotonin syndrome, severe hypotension, including orthostasis, syncope (additive effects, yohimbe inhibits monoamine oxidase)

• ziprasidone
Dilaudid (hydromorphone)

+

ziprasidone

1 interaction

Avoid/Use Alternative

hydromorphone + ziprasidone

use alternative or monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation/paralytic ileus (additive effects)

• zolmitriptan
Dilaudid (hydromorphone)

+

zolmitriptan

1 interaction

Avoid/Use Alternative

hydromorphone + zolmitriptan

use alternative or monitor respiratory rate, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome (additive effects)

• zuranolone
Dilaudid (hydromorphone)

+

zuranolone

1 interaction

Avoid/Use Alternative

hydromorphone + zuranolone

use alternative or monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

Monitor/Modify Tx

• acebutolol
Dilaudid (hydromorphone)

+

acebutolol

1 interaction

Monitor/Modify Tx

hydromorphone + acebutolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• alfuzosin
Dilaudid (hydromorphone)

+

alfuzosin

1 interaction

Monitor/Modify Tx

hydromorphone + alfuzosin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• aliskiren
Dilaudid (hydromorphone)

+

aliskiren

1 interaction

Monitor/Modify Tx

hydromorphone + aliskiren

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• allopurinol
Dilaudid (hydromorphone)

+

allopurinol

1 interaction

Monitor/Modify Tx

hydromorphone + allopurinol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• alprostadil intracavernous
Dilaudid (hydromorphone)

+

alprostadil intracavernous

1 interaction

Monitor/Modify Tx

hydromorphone + alprostadil intracavernous

monitor BP: combo may increase risk of severe hypotension, including orthostasis, syncope (additive effects)

• amantadine
Dilaudid (hydromorphone)

+

amantadine

1 interaction

Monitor/Modify Tx

hydromorphone + amantadine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• amifostine
Dilaudid (hydromorphone)

+

amifostine

1 interaction

Monitor/Modify Tx

hydromorphone + amifostine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• amiloride
Dilaudid (hydromorphone)

+

amiloride

1 interaction

Monitor/Modify Tx

hydromorphone + amiloride

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. amiloride efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• amlodipine
Dilaudid (hydromorphone)

+

amlodipine

1 interaction

Monitor/Modify Tx

hydromorphone + amlodipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• apomorphine
Dilaudid (hydromorphone)

+

apomorphine

1 interaction

Monitor/Modify Tx

hydromorphone + apomorphine

monitor respiratory rate, BP, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• apraclonidine ophthalmic
Dilaudid (hydromorphone)

+

apraclonidine ophthalmic

1 interaction

Monitor/Modify Tx

hydromorphone + apraclonidine ophthalmic

monitor respiratory rate, BP, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx if apraclonidine IOP adjunct use; postop use OK: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• aprocitentan
Dilaudid (hydromorphone)

+

aprocitentan

1 interaction

Monitor/Modify Tx

hydromorphone + aprocitentan

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• aripiprazole bimonthly injection
Dilaudid (hydromorphone)

+

aripiprazole bimonthly injection

1 interaction

Monitor/Modify Tx

hydromorphone + aripiprazole bimonthly injection

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• aripiprazole lauroxil
Dilaudid (hydromorphone)

+

aripiprazole lauroxil

1 interaction

Monitor/Modify Tx

hydromorphone + aripiprazole lauroxil

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• aripiprazole monthly injection
Dilaudid (hydromorphone)

+

aripiprazole monthly injection

1 interaction

Monitor/Modify Tx

hydromorphone + aripiprazole monthly injection

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• aripiprazole oral
Dilaudid (hydromorphone)

+

aripiprazole oral

1 interaction

Monitor/Modify Tx

hydromorphone + aripiprazole oral

monitor BP, respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• articaine
Dilaudid (hydromorphone)

+

articaine

1 interaction

Monitor/Modify Tx

hydromorphone + articaine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• asenapine
Dilaudid (hydromorphone)

+

asenapine

1 interaction

Monitor/Modify Tx

hydromorphone + asenapine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• atenolol
Dilaudid (hydromorphone)

+

atenolol

1 interaction

Monitor/Modify Tx

hydromorphone + atenolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• atracurium
Dilaudid (hydromorphone)

+

atracurium

1 interaction

Monitor/Modify Tx

hydromorphone + atracurium

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of respiratory depression, potentiate, prolong neuromuscular blockade (additive effects)

• avanafil
Dilaudid (hydromorphone)

+

avanafil

1 interaction

Monitor/Modify Tx

hydromorphone + avanafil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• azilsartan medoxomil
Dilaudid (hydromorphone)

+

azilsartan medoxomil

1 interaction

Monitor/Modify Tx

hydromorphone + azilsartan medoxomil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• baclofen
Dilaudid (hydromorphone)

+

baclofen

1 interaction

Monitor/Modify Tx

hydromorphone + baclofen

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• baclofen intrathecal
Dilaudid (hydromorphone)

+

baclofen intrathecal

1 interaction

Monitor/Modify Tx

hydromorphone + baclofen intrathecal

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• benazepril
Dilaudid (hydromorphone)

+

benazepril

1 interaction

Monitor/Modify Tx

hydromorphone + benazepril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• berberine
Dilaudid (hydromorphone)

+

berberine

1 interaction

Monitor/Modify Tx

hydromorphone + berberine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• betaxolol
Dilaudid (hydromorphone)

+

betaxolol

1 interaction

Monitor/Modify Tx

hydromorphone + betaxolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• betaxolol ophthalmic
Dilaudid (hydromorphone)

+

betaxolol ophthalmic

1 interaction

Monitor/Modify Tx

hydromorphone + betaxolol ophthalmic

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• bethanechol
Dilaudid (hydromorphone)

+

bethanechol

1 interaction

Monitor/Modify Tx

hydromorphone + bethanechol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• bexagliflozin
Dilaudid (hydromorphone)

+

bexagliflozin

1 interaction

Monitor/Modify Tx

hydromorphone + bexagliflozin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• bisoprolol
Dilaudid (hydromorphone)

+

bisoprolol

1 interaction

Monitor/Modify Tx

hydromorphone + bisoprolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• bortezomib
Dilaudid (hydromorphone)

+

bortezomib

1 interaction

Monitor/Modify Tx

hydromorphone + bortezomib

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• brexpiprazole
Dilaudid (hydromorphone)

+

brexpiprazole

1 interaction

Monitor/Modify Tx

hydromorphone + brexpiprazole

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• brimonidine ophthalmic
Dilaudid (hydromorphone)

+

brimonidine ophthalmic

1 interaction

Monitor/Modify Tx

hydromorphone + brimonidine ophthalmic

if elevated IOP or presbyopia use, monitor BP, respiratory rate; decrease dose of one or both drugs, use lowest effective doses and shortest duration of concomitant treatment; OTC ocular redness use OK: combo may increase risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• brimonidine topical
Dilaudid (hydromorphone)

+

brimonidine topical

1 interaction

Monitor/Modify Tx

hydromorphone + brimonidine topical

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• brivaracetam
Dilaudid (hydromorphone)

+

brivaracetam

1 interaction

Monitor/Modify Tx

hydromorphone + brivaracetam

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• brompheniramine
Dilaudid (hydromorphone)

+

brompheniramine

1 interaction

Monitor/Modify Tx

hydromorphone + brompheniramine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• bumetanide
Dilaudid (hydromorphone)

+

bumetanide

1 interaction

Monitor/Modify Tx

hydromorphone + bumetanide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. bumetanide efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• bupivacaine
Dilaudid (hydromorphone)

+

bupivacaine

1 interaction

Monitor/Modify Tx

hydromorphone + bupivacaine

monitor BP, HR: combo may incr. risk of severe hypotension (including orthostasis, syncope), bradycardia (additive effects)

• bupivacaine liposomal
Dilaudid (hydromorphone)

+

bupivacaine liposomal

1 interaction

Monitor/Modify Tx

hydromorphone + bupivacaine liposomal

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• bupropion
Dilaudid (hydromorphone)

+

bupropion

1 interaction

Monitor/Modify Tx

hydromorphone + bupropion

consider lower bupropion doses: combo may incr. risk of seizures (additive effects)

• cabergoline
Dilaudid (hydromorphone)

+

cabergoline

1 interaction

Monitor/Modify Tx

hydromorphone + cabergoline

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• canagliflozin
Dilaudid (hydromorphone)

+

canagliflozin

1 interaction

Monitor/Modify Tx

hydromorphone + canagliflozin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• candesartan cilexetil
Dilaudid (hydromorphone)

+

candesartan cilexetil

1 interaction

Monitor/Modify Tx

hydromorphone + candesartan cilexetil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• cannabidiol
Dilaudid (hydromorphone)

+

cannabidiol

1 interaction

Monitor/Modify Tx

hydromorphone + cannabidiol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• cannabis
Dilaudid (hydromorphone)

+

cannabis

1 interaction

Monitor/Modify Tx

hydromorphone + cannabis

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• captopril
Dilaudid (hydromorphone)

+

captopril

1 interaction

Monitor/Modify Tx

hydromorphone + captopril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• carbinoxamine
Dilaudid (hydromorphone)

+

carbinoxamine

1 interaction

Monitor/Modify Tx

hydromorphone + carbinoxamine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• cariprazine
Dilaudid (hydromorphone)

+

cariprazine

1 interaction

Monitor/Modify Tx

hydromorphone + cariprazine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• carisoprodol
Dilaudid (hydromorphone)

+

carisoprodol

1 interaction

Monitor/Modify Tx

hydromorphone + carisoprodol

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• carteolol ophthalmic
Dilaudid (hydromorphone)

+

carteolol ophthalmic

1 interaction

Monitor/Modify Tx

hydromorphone + carteolol ophthalmic

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• carvedilol
Dilaudid (hydromorphone)

+

carvedilol

1 interaction

Monitor/Modify Tx

hydromorphone + carvedilol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• cenobamate
Dilaudid (hydromorphone)

+

cenobamate

1 interaction

Monitor/Modify Tx

hydromorphone + cenobamate

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• cetirizine
Dilaudid (hydromorphone)

+

cetirizine

1 interaction

Monitor/Modify Tx

hydromorphone + cetirizine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• chamomile, German
Dilaudid (hydromorphone)

+

chamomile, German

1 interaction

Monitor/Modify Tx

hydromorphone + chamomile, German

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• chlophedianol
Dilaudid (hydromorphone)

+

chlophedianol

1 interaction

Monitor/Modify Tx

hydromorphone + chlophedianol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• chlorcyclizine
Dilaudid (hydromorphone)

+

chlorcyclizine

1 interaction

Monitor/Modify Tx

hydromorphone + chlorcyclizine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• chloroprocaine
Dilaudid (hydromorphone)

+

chloroprocaine

1 interaction

Monitor/Modify Tx

hydromorphone + chloroprocaine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• chlorothiazide
Dilaudid (hydromorphone)

+

chlorothiazide

1 interaction

Monitor/Modify Tx

hydromorphone + chlorothiazide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. chlorothiazide efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• chlorpheniramine
Dilaudid (hydromorphone)

+

chlorpheniramine

1 interaction

Monitor/Modify Tx

hydromorphone + chlorpheniramine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• chlorpromazine
Dilaudid (hydromorphone)

+

chlorpromazine

1 interaction

Monitor/Modify Tx

hydromorphone + chlorpromazine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• chlorthalidone
Dilaudid (hydromorphone)

+

chlorthalidone

1 interaction

Monitor/Modify Tx

hydromorphone + chlorthalidone

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. chlorthalidone efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• chlorzoxazone
Dilaudid (hydromorphone)

+

chlorzoxazone

1 interaction

Monitor/Modify Tx

hydromorphone + chlorzoxazone

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• cilostazol
Dilaudid (hydromorphone)

+

cilostazol

1 interaction

Monitor/Modify Tx

hydromorphone + cilostazol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• cisatracurium
Dilaudid (hydromorphone)

+

cisatracurium

1 interaction

Monitor/Modify Tx

hydromorphone + cisatracurium

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of respiratory depression, potentiate, prolong neuromuscular blockade (additive effects)

• clemastine
Dilaudid (hydromorphone)

+

clemastine

1 interaction

Monitor/Modify Tx

hydromorphone + clemastine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• clevidipine
Dilaudid (hydromorphone)

+

clevidipine

1 interaction

Monitor/Modify Tx

hydromorphone + clevidipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• clofarabine
Dilaudid (hydromorphone)

+

clofarabine

1 interaction

Monitor/Modify Tx

hydromorphone + clofarabine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• coenzyme Q-10
Dilaudid (hydromorphone)

+

coenzyme Q-10

1 interaction

Monitor/Modify Tx

hydromorphone + coenzyme Q-10

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• cyproheptadine
Dilaudid (hydromorphone)

+

cyproheptadine

1 interaction

Monitor/Modify Tx

hydromorphone + cyproheptadine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• dantrolene
Dilaudid (hydromorphone)

+

dantrolene

1 interaction

Monitor/Modify Tx

hydromorphone + dantrolene

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• dapagliflozin
Dilaudid (hydromorphone)

+

dapagliflozin

1 interaction

Monitor/Modify Tx

hydromorphone + dapagliflozin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• daridorexant
Dilaudid (hydromorphone)

+

daridorexant

1 interaction

Monitor/Modify Tx

hydromorphone + daridorexant

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• darifenacin
Dilaudid (hydromorphone)

+

darifenacin

1 interaction

Monitor/Modify Tx

hydromorphone + darifenacin

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• denileukin diftitox
Dilaudid (hydromorphone)

+

denileukin diftitox

1 interaction

Monitor/Modify Tx

hydromorphone + denileukin diftitox

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• desflurane
Dilaudid (hydromorphone)

+

desflurane

1 interaction

Monitor/Modify Tx

hydromorphone + desflurane

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• desmopressin
Dilaudid (hydromorphone)

+

desmopressin

1 interaction

Monitor/Modify Tx

hydromorphone + desmopressin

monitor sodium: combo may incr. risk of hyponatremia, including life-threatening (additive effects)

• deutetrabenazine
Dilaudid (hydromorphone)

+

deutetrabenazine

1 interaction

Monitor/Modify Tx

hydromorphone + deutetrabenazine

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• dexbrompheniramine
Dilaudid (hydromorphone)

+

dexbrompheniramine

1 interaction

Monitor/Modify Tx

hydromorphone + dexbrompheniramine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• dexchlorpheniramine
Dilaudid (hydromorphone)

+

dexchlorpheniramine

1 interaction

Monitor/Modify Tx

hydromorphone + dexchlorpheniramine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• dexmedetomidine
Dilaudid (hydromorphone)

+

dexmedetomidine

1 interaction

Monitor/Modify Tx

hydromorphone + dexmedetomidine

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• dexmedetomidine injection
Dilaudid (hydromorphone)

+

dexmedetomidine injection

1 interaction

Monitor/Modify Tx

hydromorphone + dexmedetomidine injection

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe or life-threatening hypotension, including orthostasis, syncope (additive effects)

• dichlorphenamide
Dilaudid (hydromorphone)

+

dichlorphenamide

1 interaction

Monitor/Modify Tx

hydromorphone + dichlorphenamide

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• difelikefalin
Dilaudid (hydromorphone)

+

difelikefalin

1 interaction

Monitor/Modify Tx

hydromorphone + difelikefalin

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• difenoxin
Dilaudid (hydromorphone)

+

difenoxin

1 interaction

Monitor/Modify Tx

hydromorphone + difenoxin

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus (additive effects)

• diltiazem
Dilaudid (hydromorphone)

+

diltiazem

1 interaction

Monitor/Modify Tx

hydromorphone + diltiazem

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• dimenhydrinate
Dilaudid (hydromorphone)

+

dimenhydrinate

1 interaction

Monitor/Modify Tx

hydromorphone + dimenhydrinate

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• dinutuximab
Dilaudid (hydromorphone)

+

dinutuximab

1 interaction

Monitor/Modify Tx

hydromorphone + dinutuximab

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• diphenhydramine
Dilaudid (hydromorphone)

+

diphenhydramine

1 interaction

Monitor/Modify Tx

hydromorphone + diphenhydramine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• diphenoxylate
Dilaudid (hydromorphone)

+

diphenoxylate

1 interaction

Monitor/Modify Tx

hydromorphone + diphenoxylate

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• dipyridamole
Dilaudid (hydromorphone)

+

dipyridamole

1 interaction

Monitor/Modify Tx

hydromorphone + dipyridamole

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• domperidone
Dilaudid (hydromorphone)

+

domperidone

1 interaction

Monitor/Modify Tx

hydromorphone + domperidone

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may decr. domperidone efficacy (additive effects; antagonistic effects)

• doxazosin
Dilaudid (hydromorphone)

+

doxazosin

1 interaction

Monitor/Modify Tx

hydromorphone + doxazosin

monitor BP, especially during doxazosin initiation/titration: combo may incr. doxazosin levels, risk of severe hypotension (including orthostasis, syncope), other adverse effects (absorption increased, slower GI transit due to opioid effects, additive effects)

• dronabinol
Dilaudid (hydromorphone)

+

dronabinol

1 interaction

Monitor/Modify Tx

hydromorphone + dronabinol

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• droperidol
Dilaudid (hydromorphone)

+

droperidol

1 interaction

Monitor/Modify Tx

hydromorphone + droperidol

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• efavirenz
Dilaudid (hydromorphone)

+

efavirenz

1 interaction

Monitor/Modify Tx

hydromorphone + efavirenz

monitor respiratory rate; consider decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• elinzanetant
Dilaudid (hydromorphone)

+

elinzanetant

1 interaction

Monitor/Modify Tx

hydromorphone + elinzanetant

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• empagliflozin
Dilaudid (hydromorphone)

+

empagliflozin

1 interaction

Monitor/Modify Tx

hydromorphone + empagliflozin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• enalapril
Dilaudid (hydromorphone)

+

enalapril

1 interaction

Monitor/Modify Tx

hydromorphone + enalapril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• enalaprilat
Dilaudid (hydromorphone)

+

enalaprilat

1 interaction

Monitor/Modify Tx

hydromorphone + enalaprilat

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• entacapone
Dilaudid (hydromorphone)

+

entacapone

1 interaction

Monitor/Modify Tx

hydromorphone + entacapone

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• entrectinib
Dilaudid (hydromorphone)

+

entrectinib

1 interaction

Monitor/Modify Tx

hydromorphone + entrectinib

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• eplerenone
Dilaudid (hydromorphone)

+

eplerenone

1 interaction

Monitor/Modify Tx

hydromorphone + eplerenone

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. eplerenone efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• epoprostenol
Dilaudid (hydromorphone)

+

epoprostenol

1 interaction

Monitor/Modify Tx

hydromorphone + epoprostenol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• ertugliflozin
Dilaudid (hydromorphone)

+

ertugliflozin

1 interaction

Monitor/Modify Tx

hydromorphone + ertugliflozin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• eslicarbazepine acetate
Dilaudid (hydromorphone)

+

eslicarbazepine acetate

1 interaction

Monitor/Modify Tx

hydromorphone + eslicarbazepine acetate

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• esmolol
Dilaudid (hydromorphone)

+

esmolol

1 interaction

Monitor/Modify Tx

hydromorphone + esmolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• eszopiclone
Dilaudid (hydromorphone)

+

eszopiclone

1 interaction

Monitor/Modify Tx

hydromorphone + eszopiclone

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• ethacrynic acid
Dilaudid (hydromorphone)

+

ethacrynic acid

1 interaction

Monitor/Modify Tx

hydromorphone + ethacrynic acid

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. ethacrynic acid efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• ethanol (in some formulations)
Dilaudid (hydromorphone)

+

ethanol (in some formulations)

1 interaction

Monitor/Modify Tx

hydromorphone + ethanol (in some formulations)

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• ethosuximide
Dilaudid (hydromorphone)

+

ethosuximide

1 interaction

Monitor/Modify Tx

hydromorphone + ethosuximide

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• etripamil nasal
Dilaudid (hydromorphone)

+

etripamil nasal

1 interaction

Monitor/Modify Tx

hydromorphone + etripamil nasal

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• felbamate
Dilaudid (hydromorphone)

+

felbamate

1 interaction

Monitor/Modify Tx

hydromorphone + felbamate

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• felodipine
Dilaudid (hydromorphone)

+

felodipine

1 interaction

Monitor/Modify Tx

hydromorphone + felodipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• fenoldopam
Dilaudid (hydromorphone)

+

fenoldopam

1 interaction

Monitor/Modify Tx

hydromorphone + fenoldopam

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• ferumoxytol
Dilaudid (hydromorphone)

+

ferumoxytol

1 interaction

Monitor/Modify Tx

hydromorphone + ferumoxytol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• fesoterodine
Dilaudid (hydromorphone)

+

fesoterodine

1 interaction

Monitor/Modify Tx

hydromorphone + fesoterodine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• flaxseed
Dilaudid (hydromorphone)

+

flaxseed

1 interaction

Monitor/Modify Tx

hydromorphone + flaxseed

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• flibanserin
Dilaudid (hydromorphone)

+

flibanserin

1 interaction

Monitor/Modify Tx

hydromorphone + flibanserin

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• fluphenazine
Dilaudid (hydromorphone)

+

fluphenazine

1 interaction

Monitor/Modify Tx

hydromorphone + fluphenazine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• fosinopril
Dilaudid (hydromorphone)

+

fosinopril

1 interaction

Monitor/Modify Tx

hydromorphone + fosinopril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• foslevodopa
Dilaudid (hydromorphone)

+

foslevodopa

1 interaction

Monitor/Modify Tx

hydromorphone + foslevodopa

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• fosphenytoin
Dilaudid (hydromorphone)

+

fosphenytoin

1 interaction

Monitor/Modify Tx

hydromorphone + fosphenytoin

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydromorphone levels, efficacy; may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (UGT possibly induced; additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• furosemide
Dilaudid (hydromorphone)

+

furosemide

1 interaction

Monitor/Modify Tx

hydromorphone + furosemide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. furosemide efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• ganaxolone
Dilaudid (hydromorphone)

+

ganaxolone

1 interaction

Monitor/Modify Tx

hydromorphone + ganaxolone

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• garlic
Dilaudid (hydromorphone)

+

garlic

1 interaction

Monitor/Modify Tx

hydromorphone + garlic

monitor BP w/ supplemental garlic; dietary intake OK: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• gilteritinib
Dilaudid (hydromorphone)

+

gilteritinib

1 interaction

Monitor/Modify Tx

hydromorphone + gilteritinib

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• glofitamab
Dilaudid (hydromorphone)

+

glofitamab

1 interaction

Monitor/Modify Tx

hydromorphone + glofitamab

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• glycopyrrolate
Dilaudid (hydromorphone)

+

glycopyrrolate

1 interaction

Monitor/Modify Tx

hydromorphone + glycopyrrolate

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• guanfacine
Dilaudid (hydromorphone)

+

guanfacine

1 interaction

Monitor/Modify Tx

hydromorphone + guanfacine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• hydralazine
Dilaudid (hydromorphone)

+

hydralazine

1 interaction

Monitor/Modify Tx

hydromorphone + hydralazine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• hydrochlorothiazide
Dilaudid (hydromorphone)

+

hydrochlorothiazide

1 interaction

Monitor/Modify Tx

hydromorphone + hydrochlorothiazide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. hydrochlorothiazide efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• hydroxyzine
Dilaudid (hydromorphone)

+

hydroxyzine

1 interaction

Monitor/Modify Tx

hydromorphone + hydroxyzine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• hyoscyamine
Dilaudid (hydromorphone)

+

hyoscyamine

1 interaction

Monitor/Modify Tx

hydromorphone + hyoscyamine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• ifosfamide
Dilaudid (hydromorphone)

+

ifosfamide

1 interaction

Monitor/Modify Tx

hydromorphone + ifosfamide

monitor respiratory rate; decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx; D/C one or both drugs if encephalopathy occurs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• iloperidone
Dilaudid (hydromorphone)

+

iloperidone

1 interaction

Monitor/Modify Tx

hydromorphone + iloperidone

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• iloprost
Dilaudid (hydromorphone)

+

iloprost

1 interaction

Monitor/Modify Tx

hydromorphone + iloprost

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• indapamide
Dilaudid (hydromorphone)

+

indapamide

1 interaction

Monitor/Modify Tx

hydromorphone + indapamide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. indapamide efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• iopamidol
Dilaudid (hydromorphone)

+

iopamidol

1 interaction

Monitor/Modify Tx

hydromorphone + iopamidol

caution advised if intrathecal iopamidol use; consider holding hydromorphone at least 48h before and at least 24h after intrathecal iopamidol: combo may incr. risk of seizures (additive effects)

• irbesartan
Dilaudid (hydromorphone)

+

irbesartan

1 interaction

Monitor/Modify Tx

hydromorphone + irbesartan

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• iron sucrose
Dilaudid (hydromorphone)

+

iron sucrose

1 interaction

Monitor/Modify Tx

hydromorphone + iron sucrose

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• isoflurane
Dilaudid (hydromorphone)

+

isoflurane

1 interaction

Monitor/Modify Tx

hydromorphone + isoflurane

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• isosorbide dinitrate
Dilaudid (hydromorphone)

+

isosorbide dinitrate

1 interaction

Monitor/Modify Tx

hydromorphone + isosorbide dinitrate

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• isosorbide mononitrate
Dilaudid (hydromorphone)

+

isosorbide mononitrate

1 interaction

Monitor/Modify Tx

hydromorphone + isosorbide mononitrate

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• isradipine
Dilaudid (hydromorphone)

+

isradipine

1 interaction

Monitor/Modify Tx

hydromorphone + isradipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• labetalol
Dilaudid (hydromorphone)

+

labetalol

1 interaction

Monitor/Modify Tx

hydromorphone + labetalol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• lacosamide
Dilaudid (hydromorphone)

+

lacosamide

1 interaction

Monitor/Modify Tx

hydromorphone + lacosamide

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• lamotrigine
Dilaudid (hydromorphone)

+

lamotrigine

1 interaction

Monitor/Modify Tx

hydromorphone + lamotrigine

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• landiolol
Dilaudid (hydromorphone)

+

landiolol

1 interaction

Monitor/Modify Tx

hydromorphone + landiolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• lemborexant
Dilaudid (hydromorphone)

+

lemborexant

1 interaction

Monitor/Modify Tx

hydromorphone + lemborexant

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• levetiracetam
Dilaudid (hydromorphone)

+

levetiracetam

1 interaction

Monitor/Modify Tx

hydromorphone + levetiracetam

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• levobunolol ophthalmic
Dilaudid (hydromorphone)

+

levobunolol ophthalmic

1 interaction

Monitor/Modify Tx

hydromorphone + levobunolol ophthalmic

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• levocetirizine
Dilaudid (hydromorphone)

+

levocetirizine

1 interaction

Monitor/Modify Tx

hydromorphone + levocetirizine

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• levodopa
Dilaudid (hydromorphone)

+

levodopa

1 interaction

Monitor/Modify Tx

hydromorphone + levodopa

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• lidocaine
Dilaudid (hydromorphone)

+

lidocaine

1 interaction

Monitor/Modify Tx

hydromorphone + lidocaine

monitor BP, HR: combo may incr. risk of bradycardia, severe hypotension, including orthostasis, syncope (additive effects)

• linvoseltamab
Dilaudid (hydromorphone)

+

linvoseltamab

1 interaction

Monitor/Modify Tx

hydromorphone + linvoseltamab

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• lisinopril
Dilaudid (hydromorphone)

+

lisinopril

1 interaction

Monitor/Modify Tx

hydromorphone + lisinopril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• losartan
Dilaudid (hydromorphone)

+

losartan

1 interaction

Monitor/Modify Tx

hydromorphone + losartan

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• loxapine
Dilaudid (hydromorphone)

+

loxapine

1 interaction

Monitor/Modify Tx

hydromorphone + loxapine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• lubiprostone
Dilaudid (hydromorphone)

+

lubiprostone

1 interaction

Monitor/Modify Tx

hydromorphone + lubiprostone

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• lurasidone
Dilaudid (hydromorphone)

+

lurasidone

1 interaction

Monitor/Modify Tx

hydromorphone + lurasidone

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• magnesium sulfate
Dilaudid (hydromorphone)

+

magnesium sulfate

1 interaction

Monitor/Modify Tx

hydromorphone + magnesium sulfate

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• mannitol
Dilaudid (hydromorphone)

+

mannitol

1 interaction

Monitor/Modify Tx

hydromorphone + mannitol

monitor BP, consider incr. mannitol dose: combo may decr. mannitol efficacy (antagonistic effects, opioids may induce antidiuretic hormone release)

• maraviroc
Dilaudid (hydromorphone)

+

maraviroc

1 interaction

Monitor/Modify Tx

hydromorphone + maraviroc

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• meclizine
Dilaudid (hydromorphone)

+

meclizine

1 interaction

Monitor/Modify Tx

hydromorphone + meclizine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• melatonin
Dilaudid (hydromorphone)

+

melatonin

1 interaction

Monitor/Modify Tx

hydromorphone + melatonin

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• mepivacaine
Dilaudid (hydromorphone)

+

mepivacaine

1 interaction

Monitor/Modify Tx

hydromorphone + mepivacaine

monitor BP, HR: combo may incr. risk of bradycardia, severe hypotension, including orthostasis, syncope (additive effects)

• meprobamate
Dilaudid (hydromorphone)

+

meprobamate

1 interaction

Monitor/Modify Tx

hydromorphone + meprobamate

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• methocarbamol
Dilaudid (hydromorphone)

+

methocarbamol

1 interaction

Monitor/Modify Tx

hydromorphone + methocarbamol

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• methohexital
Dilaudid (hydromorphone)

+

methohexital

1 interaction

Monitor/Modify Tx

hydromorphone + methohexital

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• methsuximide
Dilaudid (hydromorphone)

+

methsuximide

1 interaction

Monitor/Modify Tx

hydromorphone + methsuximide

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• methyldopa
Dilaudid (hydromorphone)

+

methyldopa

1 interaction

Monitor/Modify Tx

hydromorphone + methyldopa

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• metolazone
Dilaudid (hydromorphone)

+

metolazone

1 interaction

Monitor/Modify Tx

hydromorphone + metolazone

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. metolazone efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• metoprolol
Dilaudid (hydromorphone)

+

metoprolol

1 interaction

Monitor/Modify Tx

hydromorphone + metoprolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• metyrapone
Dilaudid (hydromorphone)

+

metyrapone

1 interaction

Monitor/Modify Tx

hydromorphone + metyrapone

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• metyrosine
Dilaudid (hydromorphone)

+

metyrosine

1 interaction

Monitor/Modify Tx

hydromorphone + metyrosine

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• milrinone
Dilaudid (hydromorphone)

+

milrinone

1 interaction

Monitor/Modify Tx

hydromorphone + milrinone

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• milsaperidone
Dilaudid (hydromorphone)

+

milsaperidone

1 interaction

Monitor/Modify Tx

hydromorphone + milsaperidone

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• minoxidil
Dilaudid (hydromorphone)

+

minoxidil

1 interaction

Monitor/Modify Tx

hydromorphone + minoxidil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• mitotane
Dilaudid (hydromorphone)

+

mitotane

1 interaction

Monitor/Modify Tx

hydromorphone + mitotane

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• moexipril
Dilaudid (hydromorphone)

+

moexipril

1 interaction

Monitor/Modify Tx

hydromorphone + moexipril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• molindone
Dilaudid (hydromorphone)

+

molindone

1 interaction

Monitor/Modify Tx

hydromorphone + molindone

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• mosunetuzumab
Dilaudid (hydromorphone)

+

mosunetuzumab

1 interaction

Monitor/Modify Tx

hydromorphone + mosunetuzumab

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• mycophenolate mofetil
Dilaudid (hydromorphone)

+

mycophenolate mofetil

1 interaction

Monitor/Modify Tx

hydromorphone + mycophenolate mofetil

monitor respiratory rate; decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• nadolol
Dilaudid (hydromorphone)

+

nadolol

1 interaction

Monitor/Modify Tx

hydromorphone + nadolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nattokinase
Dilaudid (hydromorphone)

+

nattokinase

1 interaction

Monitor/Modify Tx

hydromorphone + nattokinase

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• naxitamab
Dilaudid (hydromorphone)

+

naxitamab

1 interaction

Monitor/Modify Tx

hydromorphone + naxitamab

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nebivolol
Dilaudid (hydromorphone)

+

nebivolol

1 interaction

Monitor/Modify Tx

hydromorphone + nebivolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nelarabine
Dilaudid (hydromorphone)

+

nelarabine

1 interaction

Monitor/Modify Tx

hydromorphone + nelarabine

monitor respiratory rate, decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx; withhold nelarabine if Grade 2 or greater somnolence occurs: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• niacin (vitamin B3)
Dilaudid (hydromorphone)

+

niacin (vitamin B3)

1 interaction

Monitor/Modify Tx

hydromorphone + niacin (vitamin B3)

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nicardipine
Dilaudid (hydromorphone)

+

nicardipine

1 interaction

Monitor/Modify Tx

hydromorphone + nicardipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nifedipine
Dilaudid (hydromorphone)

+

nifedipine

1 interaction

Monitor/Modify Tx

hydromorphone + nifedipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nimodipine
Dilaudid (hydromorphone)

+

nimodipine

1 interaction

Monitor/Modify Tx

hydromorphone + nimodipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nisoldipine
Dilaudid (hydromorphone)

+

nisoldipine

1 interaction

Monitor/Modify Tx

hydromorphone + nisoldipine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nitric oxide
Dilaudid (hydromorphone)

+

nitric oxide

1 interaction

Monitor/Modify Tx

hydromorphone + nitric oxide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nitrite
Dilaudid (hydromorphone)

+

nitrite

1 interaction

Monitor/Modify Tx

hydromorphone + nitrite

monitor BP: combo may incr. risk of severe or life-threatening hypotension, including orthostasis, syncope (additive effects)

• nitroglycerin
Dilaudid (hydromorphone)

+

nitroglycerin

1 interaction

Monitor/Modify Tx

hydromorphone + nitroglycerin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• nitroprusside
Dilaudid (hydromorphone)

+

nitroprusside

1 interaction

Monitor/Modify Tx

hydromorphone + nitroprusside

monitor BP: combo may incr. risk of severe or life-threatening hypotension, including orthostasis, syncope (additive effects)

• obinutuzumab
Dilaudid (hydromorphone)

+

obinutuzumab

1 interaction

Monitor/Modify Tx

hydromorphone + obinutuzumab

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• olmesartan medoxomil
Dilaudid (hydromorphone)

+

olmesartan medoxomil

1 interaction

Monitor/Modify Tx

hydromorphone + olmesartan medoxomil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• opicapone
Dilaudid (hydromorphone)

+

opicapone

1 interaction

Monitor/Modify Tx

hydromorphone + opicapone

monitor BP, respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• orphenadrine
Dilaudid (hydromorphone)

+

orphenadrine

1 interaction

Monitor/Modify Tx

hydromorphone + orphenadrine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• oxcarbazepine
Dilaudid (hydromorphone)

+

oxcarbazepine

1 interaction

Monitor/Modify Tx

hydromorphone + oxcarbazepine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• oxybutynin
Dilaudid (hydromorphone)

+

oxybutynin

1 interaction

Monitor/Modify Tx

hydromorphone + oxybutynin

monitor respiratory rate; decr. dose of one or both drugs or consider oxybutynin transdermal patch, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention; somnolence less likely with oxybutynin transdermal patch (additive effects)

• paliperidone
Dilaudid (hydromorphone)

+

paliperidone

1 interaction

Monitor/Modify Tx

hydromorphone + paliperidone

monitor respiratory rate, BP, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• palopegteriparatide
Dilaudid (hydromorphone)

+

palopegteriparatide

1 interaction

Monitor/Modify Tx

hydromorphone + palopegteriparatide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• pamabrom
Dilaudid (hydromorphone)

+

pamabrom

1 interaction

Monitor/Modify Tx

hydromorphone + pamabrom

monitor BP, consider incr. pamabrom dose: combo may decr. pamabrom efficacy (antagonistic effects, opioids may induce antidiuretic hormone release)

• passion flower
Dilaudid (hydromorphone)

+

passion flower

1 interaction

Monitor/Modify Tx

hydromorphone + passion flower

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• pegvisomant
Dilaudid (hydromorphone)

+

pegvisomant

1 interaction

Monitor/Modify Tx

hydromorphone + pegvisomant

monitor IGF-1 levels, consider incr. pegvisomant dose: combo may decr. response to pegvisomant (mechanism unknown)

• pentamidine
Dilaudid (hydromorphone)

+

pentamidine

1 interaction

Monitor/Modify Tx

hydromorphone + pentamidine

monitor BP: combo may incr. risk of severe or life-threatening hypotension, including orthostasis, syncope (additive effects)

• pentobarbital
Dilaudid (hydromorphone)

+

pentobarbital

1 interaction

Monitor/Modify Tx

hydromorphone + pentobarbital

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• perampanel
Dilaudid (hydromorphone)

+

perampanel

1 interaction

Monitor/Modify Tx

hydromorphone + perampanel

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• perindopril
Dilaudid (hydromorphone)

+

perindopril

1 interaction

Monitor/Modify Tx

hydromorphone + perindopril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• perphenazine
Dilaudid (hydromorphone)

+

perphenazine

1 interaction

Monitor/Modify Tx

hydromorphone + perphenazine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• pheniramine
Dilaudid (hydromorphone)

+

pheniramine

1 interaction

Monitor/Modify Tx

hydromorphone + pheniramine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• phenoxybenzamine
Dilaudid (hydromorphone)

+

phenoxybenzamine

1 interaction

Monitor/Modify Tx

hydromorphone + phenoxybenzamine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• phentolamine
Dilaudid (hydromorphone)

+

phentolamine

1 interaction

Monitor/Modify Tx

hydromorphone + phentolamine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• phenytoin
Dilaudid (hydromorphone)

+

phenytoin

1 interaction

Monitor/Modify Tx

hydromorphone + phenytoin

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may decr. hydromorphone levels, efficacy; may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (UGT possibly induced; additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• pimozide
Dilaudid (hydromorphone)

+

pimozide

1 interaction

Monitor/Modify Tx

hydromorphone + pimozide

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• pindolol
Dilaudid (hydromorphone)

+

pindolol

1 interaction

Monitor/Modify Tx

hydromorphone + pindolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• pramipexole
Dilaudid (hydromorphone)

+

pramipexole

1 interaction

Monitor/Modify Tx

hydromorphone + pramipexole

monitor respiratory rate, BP, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• prazosin
Dilaudid (hydromorphone)

+

prazosin

1 interaction

Monitor/Modify Tx

hydromorphone + prazosin

monitor BP, especially during prazosin initiation/titration: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• primidone
Dilaudid (hydromorphone)

+

primidone

1 interaction

Monitor/Modify Tx

hydromorphone + primidone

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• propafenone
Dilaudid (hydromorphone)

+

propafenone

1 interaction

Monitor/Modify Tx

hydromorphone + propafenone

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• propofol
Dilaudid (hydromorphone)

+

propofol

1 interaction

Monitor/Modify Tx

hydromorphone + propofol

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• propranolol
Dilaudid (hydromorphone)

+

propranolol

1 interaction

Monitor/Modify Tx

hydromorphone + propranolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• pyrilamine
Dilaudid (hydromorphone)

+

pyrilamine

1 interaction

Monitor/Modify Tx

hydromorphone + pyrilamine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• quetiapine
Dilaudid (hydromorphone)

+

quetiapine

1 interaction

Monitor/Modify Tx

hydromorphone + quetiapine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation/paralytic ileus, urinary retention (additive effects)

• quinapril
Dilaudid (hydromorphone)

+

quinapril

1 interaction

Monitor/Modify Tx

hydromorphone + quinapril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• ramelteon
Dilaudid (hydromorphone)

+

ramelteon

1 interaction

Monitor/Modify Tx

hydromorphone + ramelteon

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• ramipril
Dilaudid (hydromorphone)

+

ramipril

1 interaction

Monitor/Modify Tx

hydromorphone + ramipril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• remifentanil
Dilaudid (hydromorphone)

+

remifentanil

1 interaction

Monitor/Modify Tx

hydromorphone + remifentanil

monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• repotrectinib
Dilaudid (hydromorphone)

+

repotrectinib

1 interaction

Monitor/Modify Tx

hydromorphone + repotrectinib

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• riociguat
Dilaudid (hydromorphone)

+

riociguat

1 interaction

Monitor/Modify Tx

hydromorphone + riociguat

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• risperidone
Dilaudid (hydromorphone)

+

risperidone

1 interaction

Monitor/Modify Tx

hydromorphone + risperidone

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• rocuronium
Dilaudid (hydromorphone)

+

rocuronium

1 interaction

Monitor/Modify Tx

hydromorphone + rocuronium

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of respiratory depression, potentiate, prolong neuromuscular blockade (additive effects)

• ropinirole
Dilaudid (hydromorphone)

+

ropinirole

1 interaction

Monitor/Modify Tx

hydromorphone + ropinirole

monitor respiratory rate, BP, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• ropivacaine
Dilaudid (hydromorphone)

+

ropivacaine

1 interaction

Monitor/Modify Tx

hydromorphone + ropivacaine

monitor BP, HR: combo may incr. risk of severe hypotension (including orthostasis, syncope), bradycardia (additive effects)

• rotigotine transdermal
Dilaudid (hydromorphone)

+

rotigotine transdermal

1 interaction

Monitor/Modify Tx

hydromorphone + rotigotine transdermal

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• rufinamide
Dilaudid (hydromorphone)

+

rufinamide

1 interaction

Monitor/Modify Tx

hydromorphone + rufinamide

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• sacubitril
Dilaudid (hydromorphone)

+

sacubitril

1 interaction

Monitor/Modify Tx

hydromorphone + sacubitril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• selinexor
Dilaudid (hydromorphone)

+

selinexor

1 interaction

Monitor/Modify Tx

hydromorphone + selinexor

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• sevoflurane
Dilaudid (hydromorphone)

+

sevoflurane

1 interaction

Monitor/Modify Tx

hydromorphone + sevoflurane

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• sildenafil
Dilaudid (hydromorphone)

+

sildenafil

1 interaction

Monitor/Modify Tx

hydromorphone + sildenafil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• silodosin
Dilaudid (hydromorphone)

+

silodosin

1 interaction

Monitor/Modify Tx

hydromorphone + silodosin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• sodium ferric gluconate complex
Dilaudid (hydromorphone)

+

sodium ferric gluconate complex

1 interaction

Monitor/Modify Tx

hydromorphone + sodium ferric gluconate complex

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• solifenacin
Dilaudid (hydromorphone)

+

solifenacin

1 interaction

Monitor/Modify Tx

hydromorphone + solifenacin

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of severe constipation, paralytic ileus, urinary retention, profound CNS and respiratory depression, psychomotor impairment (additive effects)

• sotagliflozin
Dilaudid (hydromorphone)

+

sotagliflozin

1 interaction

Monitor/Modify Tx

hydromorphone + sotagliflozin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• sotalol
Dilaudid (hydromorphone)

+

sotalol

1 interaction

Monitor/Modify Tx

hydromorphone + sotalol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• sparsentan
Dilaudid (hydromorphone)

+

sparsentan

1 interaction

Monitor/Modify Tx

hydromorphone + sparsentan

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• spironolactone
Dilaudid (hydromorphone)

+

spironolactone

1 interaction

Monitor/Modify Tx

hydromorphone + spironolactone

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. spironolactone efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• stiripentol
Dilaudid (hydromorphone)

+

stiripentol

1 interaction

Monitor/Modify Tx

hydromorphone + stiripentol

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• succinylcholine
Dilaudid (hydromorphone)

+

succinylcholine

1 interaction

Monitor/Modify Tx

hydromorphone + succinylcholine

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of respiratory depression, potentiate, prolong neuromuscular blockade, bradycardia, sinus arrest (additive effects)

• sufentanil
Dilaudid (hydromorphone)

+

sufentanil

1 interaction

Monitor/Modify Tx

hydromorphone + sufentanil

monitor respiratory rate, BP, serotonin syndrome sx, especially during initiation/titration; decr. sufentanil start dose, consider decr. hydromorphone dose, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, serotonin syndrome, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus (additive effects)

• suvorexant
Dilaudid (hydromorphone)

+

suvorexant

1 interaction

Monitor/Modify Tx

hydromorphone + suvorexant

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• tadalafil
Dilaudid (hydromorphone)

+

tadalafil

1 interaction

Monitor/Modify Tx

hydromorphone + tadalafil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• tagraxofusp
Dilaudid (hydromorphone)

+

tagraxofusp

1 interaction

Monitor/Modify Tx

hydromorphone + tagraxofusp

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• tamsulosin
Dilaudid (hydromorphone)

+

tamsulosin

1 interaction

Monitor/Modify Tx

hydromorphone + tamsulosin

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• tasimelteon
Dilaudid (hydromorphone)

+

tasimelteon

1 interaction

Monitor/Modify Tx

hydromorphone + tasimelteon

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• taurine
Dilaudid (hydromorphone)

+

taurine

1 interaction

Monitor/Modify Tx

hydromorphone + taurine

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• telmisartan
Dilaudid (hydromorphone)

+

telmisartan

1 interaction

Monitor/Modify Tx

hydromorphone + telmisartan

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• terazosin
Dilaudid (hydromorphone)

+

terazosin

1 interaction

Monitor/Modify Tx

hydromorphone + terazosin

monitor BP, especially during terazosin initiation/titration: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• tetrabenazine
Dilaudid (hydromorphone)

+

tetrabenazine

1 interaction

Monitor/Modify Tx

hydromorphone + tetrabenazine

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• thioridazine
Dilaudid (hydromorphone)

+

thioridazine

1 interaction

Monitor/Modify Tx

hydromorphone + thioridazine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• thiotepa
Dilaudid (hydromorphone)

+

thiotepa

1 interaction

Monitor/Modify Tx

hydromorphone + thiotepa

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• thiothixene
Dilaudid (hydromorphone)

+

thiothixene

1 interaction

Monitor/Modify Tx

hydromorphone + thiothixene

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• tiagabine
Dilaudid (hydromorphone)

+

tiagabine

1 interaction

Monitor/Modify Tx

hydromorphone + tiagabine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• timolol
Dilaudid (hydromorphone)

+

timolol

1 interaction

Monitor/Modify Tx

hydromorphone + timolol

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• timolol ophthalmic
Dilaudid (hydromorphone)

+

timolol ophthalmic

1 interaction

Monitor/Modify Tx

hydromorphone + timolol ophthalmic

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• tizanidine
Dilaudid (hydromorphone)

+

tizanidine

1 interaction

Monitor/Modify Tx

hydromorphone + tizanidine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• tolcapone
Dilaudid (hydromorphone)

+

tolcapone

1 interaction

Monitor/Modify Tx

hydromorphone + tolcapone

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope (additive effects)

• tolterodine
Dilaudid (hydromorphone)

+

tolterodine

1 interaction

Monitor/Modify Tx

hydromorphone + tolterodine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• topiramate
Dilaudid (hydromorphone)

+

topiramate

1 interaction

Monitor/Modify Tx

hydromorphone + topiramate

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• torsemide
Dilaudid (hydromorphone)

+

torsemide

1 interaction

Monitor/Modify Tx

hydromorphone + torsemide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. torsemide efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• trandolapril
Dilaudid (hydromorphone)

+

trandolapril

1 interaction

Monitor/Modify Tx

hydromorphone + trandolapril

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• treprostinil
Dilaudid (hydromorphone)

+

treprostinil

1 interaction

Monitor/Modify Tx

hydromorphone + treprostinil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• triamterene
Dilaudid (hydromorphone)

+

triamterene

1 interaction

Monitor/Modify Tx

hydromorphone + triamterene

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope; may decr. triamterene efficacy (additive effects; antagonistic effects, opioids may induce antidiuretic hormone release)

• trifluoperazine
Dilaudid (hydromorphone)

+

trifluoperazine

1 interaction

Monitor/Modify Tx

hydromorphone + trifluoperazine

monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension (including orthostasis, syncope), severe constipation, paralytic ileus, urinary retention (additive effects)

• trihexyphenidyl
Dilaudid (hydromorphone)

+

trihexyphenidyl

1 interaction

Monitor/Modify Tx

hydromorphone + trihexyphenidyl

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• trimethobenzamide
Dilaudid (hydromorphone)

+

trimethobenzamide

1 interaction

Monitor/Modify Tx

hydromorphone + trimethobenzamide

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• triprolidine
Dilaudid (hydromorphone)

+

triprolidine

1 interaction

Monitor/Modify Tx

hydromorphone + triprolidine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• trospium
Dilaudid (hydromorphone)

+

trospium

1 interaction

Monitor/Modify Tx

hydromorphone + trospium

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe constipation, paralytic ileus, urinary retention (additive effects)

• valbenazine
Dilaudid (hydromorphone)

+

valbenazine

1 interaction

Monitor/Modify Tx

hydromorphone + valbenazine

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• valerian
Dilaudid (hydromorphone)

+

valerian

1 interaction

Monitor/Modify Tx

hydromorphone + valerian

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• valproic acid
Dilaudid (hydromorphone)

+

valproic acid

1 interaction

Monitor/Modify Tx

hydromorphone + valproic acid

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• valsartan
Dilaudid (hydromorphone)

+

valsartan

1 interaction

Monitor/Modify Tx

hydromorphone + valsartan

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• vardenafil
Dilaudid (hydromorphone)

+

vardenafil

1 interaction

Monitor/Modify Tx

hydromorphone + vardenafil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• vasopressin
Dilaudid (hydromorphone)

+

vasopressin

1 interaction

Monitor/Modify Tx

hydromorphone + vasopressin

monitor sodium: combo may incr. risk of hyponatremia (additive effects)

• vecuronium
Dilaudid (hydromorphone)

+

vecuronium

1 interaction

Monitor/Modify Tx

hydromorphone + vecuronium

monitor respiratory rate; consider decr. dose of one or both drugs: combo may incr. risk of respiratory depression, potentiate, prolong neuromuscular blockade (additive effects)

• verapamil
Dilaudid (hydromorphone)

+

verapamil

1 interaction

Monitor/Modify Tx

hydromorphone + verapamil

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• vigabatrin
Dilaudid (hydromorphone)

+

vigabatrin

1 interaction

Monitor/Modify Tx

hydromorphone + vigabatrin

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)

• viloxazine
Dilaudid (hydromorphone)

+

viloxazine

1 interaction

Monitor/Modify Tx

hydromorphone + viloxazine

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• vosoritide
Dilaudid (hydromorphone)

+

vosoritide

1 interaction

Monitor/Modify Tx

hydromorphone + vosoritide

monitor BP: combo may incr. risk of severe hypotension, including orthostasis, syncope (additive effects)

• zaleplon
Dilaudid (hydromorphone)

+

zaleplon

1 interaction

Monitor/Modify Tx

hydromorphone + zaleplon

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• ziconotide
Dilaudid (hydromorphone)

+

ziconotide

1 interaction

Monitor/Modify Tx

hydromorphone + ziconotide

monitor respiratory rate; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• zolpidem
Dilaudid (hydromorphone)

+

zolpidem

1 interaction

Monitor/Modify Tx

hydromorphone + zolpidem

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment (additive effects)

• zonisamide
Dilaudid (hydromorphone)

+

zonisamide

1 interaction

Monitor/Modify Tx

hydromorphone + zonisamide

monitor respiratory rate, decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment; may alter seizure control (additive effects; antagonistic effects, hydromorphone may decr. seizure threshold)