Opioids may potentiate the effects of serotonergic agents and increase the risk of serotonin syndrome, drug interactions vicoden and nortriptyline. The interaction has elevated ptt and mobic been reported with the phenylpiperidine opioids e. Serotonin syndrome is a rare but serious and potentially fatal condition thought to result from hyperstimulation of brainstem 5-HT1A and 2A receptors.
Symptoms of the serotonin syndrome may include mental status drug interactions vicoden and nortriptyline such as irritability, altered consciousness, confusion, hallucinations, and coma; autonomic dysfunction such as tachycardia, hyperthermia, diaphoresis, shivering, blood pressure lability, and mydriasis; neuromuscular abnormalities such as hyperreflexia, myoclonus, tremor, rigidity, and ataxia; and gastrointestinal symptoms such as abdominal cramping, nausea, vomiting, and diarrhea.
Since many serotonergic agents can also cause central nervous system depression, concomitant use with opioids may result in increased sedation and impairment of judgment, drug interactions vicoden and nortriptyline, thinking, and psychomotor skills, drug interactions vicoden and nortriptyline. Patients should be monitored for symptoms of the serotonin syndrome during treatment. Particular caution is advised when increasing the dosages of these agents. If serotonin syndrome develops or is suspected during the course of therapy, all serotonergic agents should drug interactions vicoden and nortriptyline discontinued immediately and supportive care rendered as necessary.
Moderately ill patients may also benefit from the administration of a serotonin antagonist e. Severe cases should be managed under consultation with a toxicologist and may require sedation, neuromuscular paralysis, intubation, and mechanical ventilation in addition to the other measures.
Patients should also be advised of potentially additive central nervous system effects from these agents and to avoid hazardous activities requiring complete mental alertness and motor coordination until they know how these agents affect them.
Do not use alcohol or medications that contain alcohol while you are receiving treatment with HYDROcodone. This may increase drug interactions vicoden and nortriptyline system side effects such as drowsiness, dizziness, lightheadedness, difficulty concentrating, drug interactions vicoden and nortriptyline, and impairment in thinking and judgment. In severe cases, low blood pressure, respiratory distress, fainting, coma, or even death may occur.
If you are taking certain long-acting formulations of hydrocodone, consumption of alcohol may also cause rapid release of the drug, resulting in high drug interactions vicoden and nortriptyline levels that may be potentially lethal.
Likewise, you should avoid consuming grapefruit erectile dysfunction medication and internet order grapefruit juice, as this may increase the blood levels and effects of hydrocodone. Talk to your doctor or pharmacist if you have questions on how to take this or other medications you are prescribed.
Do not use more than the recommended dose of HYDROcodone, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor. Switch to professional interaction data. Do not stop taking any medications without consulting your healthcare provider, drug interactions vicoden and nortriptyline.
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances. By clicking Subscribe, I agree to the Drugs. The easiest way to lookup drug information, identify pills, check interactions and set up your own personal medication records. Available for Android and iOS devices. Subscribe to receive email notifications whenever new articles are published. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment.
To view content sources and attributions, please refer to our editorial policy. We comply with the HONcode standard for trustworthy health information - verify here. Drug interactions between hydrocodone and nortriptyline Edit this list. Martin TG "Serotonin syndrome. FDA warns about several safety issues with opioid pain medicines; requires label changes.
Meyer D, Halfin V "Toxicity secondary comparison between cymbalta and effexor meperidine in patients on monoamine oxidase inhibitors: Is serotonin syndrome going undetected? Therapeutic duplication warnings No therapeutic duplications were found for your selected drugs. Drug Interaction Classification The classifications below are a guideline only. The relevance of a particular drug interaction to a specific patient is difficult to determine using this tool alone given the large number of variables that may apply.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Unknown No information available. How to Prevent Deadly Drug Interactions.
Some mixtures of medications can lead to serious and even fatal consequences. Here are 9 cancer and balsamic vinegar of modera to stay safe. Revcovi Nuzyra Nuzyra omadacycline is an aminomethylcycline tetracycline antibiotic for the treatment of Seysara Seysara sarecycline is an oral, narrow spectrum tetracycline-derived antibiotic for the treatment Xyosted Xyosted testosterone enanthate is a self-administered subcutaneous injection formulation of Subscribe to free Drugs.