{"id":626530,"date":"2024-02-01T11:13:23","date_gmt":"2024-02-01T16:13:23","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=626530"},"modified":"2025-09-12T20:05:52","modified_gmt":"2025-09-13T00:05:52","slug":"oxycodone-interactions","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/oxycodone-interactions\/","title":{"rendered":"Oxycodone interactions to avoid"},"content":{"rendered":"

Oxycodone<\/span><\/a> is a prescription-only narcotic pain medication that belongs to a class of drugs known as opiates. Oxycodone is intended for acute severe or persistent severe pain for which other treatments have been inadequate. Oxycodone can be a first-choice opiate in opiate-naive patients. It has been used <\/span>off-label<\/span><\/a> for <\/span>diabetic neuropathy<\/span><\/a> and <\/span>restless leg syndrome<\/span><\/a>. Oxycodone is available in many forms and brand names, including immediate-release tablets and capsules <\/span>(Roxicodone)<\/span><\/a>, extended-release tablets <\/span>(OxyContin)<\/span><\/a>, and a concentrated oral solution.<\/span><\/p>\n

Oxycodone<\/span><\/a> can interact with a variety of other types of medications, including other <\/span>opioids<\/span><\/a>, <\/span>sleeping medications<\/span><\/a>, <\/span>antidepressants<\/span><\/a>, and sedatives. It may also interact with headache treatments, medications for nausea and vomiting, or even over-the-counter cold medications. It\u2019s essential to be aware of interactions with oxycodone if you begin therapy. Some interactions can lead to over-sedation, making it difficult to function in your daily activities. These interactions have the potential to cause life-threatening respiratory depression in some cases. Speak to your prescriber and pharmacist before taking oxycodone.<\/span><\/p>\n

Oxycodone drug interactions<\/span><\/h2>\n

Oxycodone interactions can be described in three primary forms:\u00a0<\/span><\/p>\n

    \n
  1. The interacting drug causes similar CNS depressive effects to oxycodone, and the additive effects can be dangerous.<\/span><\/li>\n
  2. The interacting drug causes an increase in oxycodone levels, leaving a patient prone to exacerbated or dangerous side effects.<\/span><\/li>\n
  3. The interacting drug causes oxycodone to be metabolized faster than intended, which may render it less effective in pain relief.<\/span><\/li>\n<\/ol>\n

    Milder side effects of opiates include drowsiness, nausea, and constipation. These will also be more severe with some drug interactions. Do not take oxycodone if you are pregnant or breastfeeding without explicit consent from your healthcare provider.<\/span><\/p>\n

    Below are some of the most common interacting classes or types of medications. You should speak to your healthcare professional for the most comprehensive list of potential interactions.<\/span><\/p>\n

    Other opioid analgesics<\/span><\/h3>\n

    Oxycodone is an opioid, and other opiate agonist medications can potentiate or make worse the depressive effects of the involved drugs. This can lead to profound respiratory depression and difficulty breathing marked sedation, and, in some rare cases, coma. Patients with a history of addiction or abuse of opiates should have counseling to this effect if opiate treatment is necessary. <\/span>Buprenorphine<\/span><\/a> products may be a better choice for these patients. Drugs purchased from non-licensed sources could be laced with opiates without the knowledge of the user, and this can be very dangerous. Patients should not take more than one opiate at a time without direct oversight by a qualified physician.<\/span><\/p>\n

    Examples:<\/b> Dilaudid<\/span><\/a> (hydromorphone), <\/span>Vicodin<\/span><\/a> (hydrocodone\/ acetaminophen),<\/span> MS Contin<\/span><\/a> (morphine), <\/span>Duragesic<\/span><\/a> (fentanyl<\/a>), Opana (oxymorphone), Vicoprofen (hydrocodone\/ ibuprofen), methadone, codeine<\/span><\/p>\n

    Benzodiazepines<\/span><\/h3>\n

    Benzodiazepines<\/span><\/a> are a class of medications used most commonly for anxiety and sedation. They cause marked CNS depression, much like opiates. The combined effects of CNS depression from opiates and benzodiazepines can also lead to respiratory depression, increased sedation, or even coma. Benzodiazepines are also a class of <\/span>controlled substances<\/span><\/a> that are abused or misused at times, and addiction is a possibility. Combining oxycodone and benzodiazepines should be done with extreme caution and under the direct supervision of a healthcare provider.<\/span><\/p>\n

    Examples:<\/b> Ativan<\/span><\/a> (lorazepam), <\/span>Klonopin<\/span><\/a> (clonazepam), <\/span>Valium<\/span><\/a> (diazepam), <\/span>Xanax<\/span><\/a> (alprazolam)<\/span><\/p>\n

    Seizure medications<\/span><\/h3>\n

    Some <\/span>seizure medications<\/span><\/a> are 3A4 inducers. This leads to oxycodone being metabolized more quickly than expected, and this could lead to subtherapeutic levels of oxycodone and insufficient pain relief. If a patient is oxycodone dependent, this could also lead to symptoms of withdrawal, such as anxiety, restlessness, nausea, vomiting, stomach cramps, and sweating. If one of these seizure medications becomes necessary, you may need to titrate the oxycodone dose in small increments with monitoring to avoid withdrawal symptoms.<\/span><\/p>\n

    Examples:<\/b> Tegretol<\/span><\/a> (carbamazepine), <\/span>Dilantin<\/span><\/a> (phenytoin)<\/span><\/p>\n

    Macrolide antibiotics<\/span><\/h3>\n

    Macrolide antibiotics<\/span><\/a> are CYP3A4 inhibitors. Oxycodone depends upon 3A4 to be metabolized and excreted from the body as designed. When 3A4 is inhibited, oxycodone levels begin to increase in the blood, and therefore, side effects, such as sedation, dizziness, or even difficulty breathing, can be exacerbated. There are likely other antibiotic class choices for many infection types that will not interfere with opiate metabolism, and it is probably safest to choose a different antibiotic. If a macrolide is the only appropriate antibiotic, your prescriber should consider lowering your oxycodone dose while on the macrolide.<\/span><\/p>\n

    Examples:<\/b> Ery-Tab<\/span><\/a> (Erythromycin), <\/span>Biaxin<\/span><\/a> (clarithromycin)<\/span><\/p>\n

    Azole antifungals<\/span><\/h3>\n

    Azole antifungals<\/span><\/a> are also 3A4 inhibitors. Similarly, they can lead to an increase in oxycodone levels. Unfortunately, there aren\u2019t many alternatives to azole antifungals when they are needed for fungal infections. Prescribers should consider lowering the dose of oxycodone while on azole therapy.\u00a0<\/span><\/p>\n

    Examples:<\/b> Ketodan<\/span><\/a> (ketoconazole), <\/span>Sporanox<\/span><\/a> (itraconazole)<\/span><\/p>\n

    Serotonergic drugs<\/span><\/h3>\n

    Oxycodone and other opioid medications can affect serotonin levels in the central nervous system. There are a variety of other drugs which interact with the serotonin receptors in the CNS as well. Combining opiates with these drugs has the potential to lead to <\/span>serotonin syndrome<\/span><\/a>, a result of too much free serotonin in the CNS. <\/span>Serotonin syndrome<\/span><\/a> can lead to agitation, insomnia, confusion, rapid heart rate, high blood pressure, and muscle twitching. While it may not happen to everyone, if the combination of oxycodone with a serotonin drug is necessary, the patient should know what symptoms to monitor for. A few different classes of serotonergic drugs may interact this way, and some examples are listed below.<\/span><\/p>\n

    Examples of serotonergic drug classes:<\/b><\/p>\n