Narcotics: Major Interactions

Question 1

BUPRENORPHINE

What drugs affect buprenorphine?

Answer 1

CNS depressants (including alcohol):
-increased sedation / dizziness

CYP3A4 inhibitors / inducers:
-alter buprenorphine’s metabolism

Drugs that can potentially cause QTc prolongation:
-may increase risk of arrhythmias

MAOI inhibitors:
-may increase sedation

Question 2

FENTANYL:

What drugs affect fentanyl?

Answer 2

Amphetamines:
-increase analgesic effects

Antipsychotics:
-enhance hypotensive effects

CNS depressants (including alcohol):
-increase sedation / dizziness

MAOI inhibitors:
-serotonin syndrome

Strong and moderate CYP3A4 inhibitors:
-decrease metabolism

Question 3

FENTANYL:

What drugs does fentanyl affect?

Answer 3

CNS depressants:

-additive respiratory / CNS depressants effects

Question 4

HYDROCODONE:

What drugs affect hydrocodone?

Answer 4

Alcohol:
-enhanced CNS depressant effect

CNS depressants:
-increase sedation / dizziness

Strong CYP2D6 inhibitors:
-decrease serum concentrations of hydrocodone active metabolites

CYP3A4 inhibitors / inducers:
-alter hydrocodone metabolism

MAO inhibitors:
-enhance adverse-toxic effects

Question 5

HYDROCODONE:

What drugs does hydrocodone affect?

Answer 5

CNS depressants:
-additive effects

SSRIs:
-may cause serotonin syndrome