All Interactions Sort By: SeverityName
Contraindicated (12)
- alvimopan
alvimopan, meperidine. receptor binding competition. Contraindicated. Alvimopan is contraindicated in opioid tolerant patients (ie, those who have taken therapeutic doses of opioids for >7 consecutive days immediately prior to taking alvimopan). Patients recently exposed to opioids are expected to be more sensitive to the effects of alvimopan and therefore may experience abdominal pain, nausea and vomiting, and diarrhea. No significant interaction is expected with concurrent use of opioid analgesics and alvimopan in patients who received opioid analgesics for 7 or fewer consecutive days prior to alvimopan.
- isocarboxazid
isocarboxazid and meperidine both increase serotonin levels. Contraindicated.isocarboxazid increases toxicity of meperidine by unknown mechanism. Contraindicated.
- linezolid
linezolid increases toxicity of meperidine by unknown mechanism. Contraindicated.
- nirmatrelvir
nirmatrelvir will increase the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.
- nirmatrelvir/ritonavir
nirmatrelvir/ritonavir will increase the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.
- phenelzine
phenelzine and meperidine both increase serotonin levels. Contraindicated.phenelzine increases toxicity of meperidine by unknown mechanism. Contraindicated.
- procarbazine
procarbazine and meperidine both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.procarbazine increases toxicity of meperidine by unknown mechanism. Contraindicated. MAOIs may potentiate CNS depression and hypotension. Do not use meperidine within 14 days of MAOI use. .
- rasagiline
rasagiline and meperidine both increase serotonin levels. Contraindicated. Risk of serious, sometimes fatal reactions from serotonin syndrome.
- safinamide
meperidine, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.
- selegiline
selegiline and meperidine both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of selegiline and initiation of analgesic.
- selegiline transdermal
selegiline transdermal increases toxicity of meperidine by unknown mechanism. Contraindicated.
- tranylcypromine
tranylcypromine and meperidine both increase serotonin levels. Contraindicated.tranylcypromine increases toxicity of meperidine by unknown mechanism. Contraindicated.
Serious - Use Alternative (59)
- amitriptyline
amitriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- amoxapine
amoxapine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- benzhydrocodone/acetaminophen
benzhydrocodone/acetaminophen, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- buprenorphine
buprenorphine, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- buprenorphine buccal
buprenorphine buccal, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- buspirone
buspirone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- butorphanol
butorphanol, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- calcium/magnesium/potassium/sodium oxybates
meperidine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- cimetidine
cimetidine increases effects of meperidine by decreasing metabolism. Avoid or Use Alternate Drug.
- citalopram
meperidine, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- clomipramine
clomipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- clonidine
clonidine, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration enhances CNS depressant effects.
- cyclobenzaprine
meperidine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.
- desipramine
desipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- desvenlafaxine
meperidine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.
- dextromethorphan
dextromethorphan and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- diazepam intranasal
diazepam intranasal, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- doxepin
doxepin and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- duloxetine
duloxetine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- eluxadoline
meperidine, eluxadoline. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that cause constipation. Increases risk for constipation related serious adverse reactions. .
- escitalopram
escitalopram and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meperidine, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- fentanyl
fentanyl, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl intranasal
fentanyl intranasal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transdermal
fentanyl transdermal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fentanyl transmucosal
fentanyl transmucosal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
- fluoxetine
fluoxetine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meperidine, fluoxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- fluvoxamine
fluvoxamine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- hydrocodone
hydrocodone, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- imipramine
imipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- levomilnacipran
levomilnacipran and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- linezolid
linezolid and meperidine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.meperidine, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- lofepramine
lofepramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- lorcaserin
meperidine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.
- maprotiline
maprotiline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- methylene blue
methylene blue and meperidine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.
- metoclopramide intranasal
meperidine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
- milnacipran
milnacipran and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- nalbuphine
nalbuphine, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- nefazodone
nefazodone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- nortriptyline
nortriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- ozanimod
ozanimod and meperidine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.
- paroxetine
paroxetine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meperidine, paroxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- pentazocine
pentazocine, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
- protriptyline
protriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- selegiline transdermal
selegiline transdermal and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- selinexor
selinexor, meperidine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
- sertraline
sertraline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.meperidine, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
- sodium oxybate
meperidine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- St John's Wort
meperidine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.
- sufentanil SL
sufentanil SL, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- tedizolid
tedizolid, meperidine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.
- tipranavir
tipranavir, meperidine. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Meperidine levels decrease, but metabolite normeperidine levels increase, increasing risk of seizure.
- tramadol
tramadol, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tramadol may reinitiate opiate dependence in pts. previously addicted to other opiates; it may also provoke withdrawal Sx. in pts. who are currently opiate dependent.
- trazodone
trazodone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- trimipramine
trimipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- valerian
valerian and meperidine both increase sedation. Avoid or Use Alternate Drug.
- venlafaxine
venlafaxine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- vilazodone
meperidine, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .
- vortioxetine
meperidine, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (223)
- 5-HTP
5-HTP and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- albuterol
meperidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
alfentanil and meperidine both increase sedation. Use Caution/Monitor.
- almotriptan
almotriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- alprazolam
alprazolam and meperidine both increase sedation. Use Caution/Monitor.
- amifampridine
meperidine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.
- amitriptyline
meperidine and amitriptyline both increase sedation. Use Caution/Monitor.
- amobarbital
amobarbital and meperidine both increase sedation. Use Caution/Monitor.
- amoxapine
meperidine and amoxapine both increase sedation. Use Caution/Monitor.
- apomorphine
meperidine and apomorphine both increase sedation. Use Caution/Monitor.
- arformoterol
meperidine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aripiprazole
meperidine and aripiprazole both increase sedation. Use Caution/Monitor.meperidine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- armodafinil
meperidine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- asenapine
meperidine, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- atazanavir
atazanavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
- azelastine
azelastine and meperidine both increase sedation. Use Caution/Monitor.
- baclofen
baclofen and meperidine both increase sedation. Use Caution/Monitor.
- belladonna and opium
meperidine and belladonna and opium both increase sedation. Use Caution/Monitor.
- benperidol
meperidine and benperidol both increase sedation. Use Caution/Monitor.
- benzphetamine
meperidine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- brexanolone
brexanolone, meperidine. Either increases toxicity of the other by sedation. Use Caution/Monitor.
- brompheniramine
brompheniramine and meperidine both increase sedation. Use Caution/Monitor.
- buprenorphine
buprenorphine and meperidine both increase sedation. Use Caution/Monitor.
- buprenorphine buccal
buprenorphine buccal and meperidine both increase sedation. Use Caution/Monitor.
- buprenorphine, long-acting injection
meperidine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
- butabarbital
butabarbital and meperidine both increase sedation. Use Caution/Monitor.
- butalbital
butalbital and meperidine both increase sedation. Use Caution/Monitor.
- butorphanol
butorphanol and meperidine both increase sedation. Use Caution/Monitor.
- caffeine
meperidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- carbinoxamine
carbinoxamine and meperidine both increase sedation. Use Caution/Monitor.
- cariprazine
meperidine, cariprazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- carisoprodol
carisoprodol and meperidine both increase sedation. Use Caution/Monitor.
- chloral hydrate
chloral hydrate and meperidine both increase sedation. Use Caution/Monitor.
- chlordiazepoxide
chlordiazepoxide and meperidine both increase sedation. Use Caution/Monitor.
- chlorpheniramine
chlorpheniramine and meperidine both increase sedation. Use Caution/Monitor.
- chlorpromazine
meperidine and chlorpromazine both increase sedation. Use Caution/Monitor.
- chlorzoxazone
chlorzoxazone and meperidine both increase sedation. Use Caution/Monitor.
- cinnarizine
cinnarizine and meperidine both increase sedation. Use Caution/Monitor.
- citalopram
citalopram and meperidine both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.
- clemastine
clemastine and meperidine both increase sedation. Use Caution/Monitor.
- clobazam
meperidine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
- clomipramine
meperidine and clomipramine both increase sedation. Use Caution/Monitor.
- clonazepam
clonazepam and meperidine both increase sedation. Use Caution/Monitor.
- clorazepate
clorazepate and meperidine both increase sedation. Use Caution/Monitor.
- clozapine
meperidine and clozapine both increase sedation. Use Caution/Monitor.meperidine, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- cocaine
cocaine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- codeine
codeine and meperidine both increase sedation. Use Caution/Monitor.
- cyclizine
cyclizine and meperidine both increase sedation. Use Caution/Monitor.
- cyclobenzaprine
cyclobenzaprine and meperidine both increase sedation. Use Caution/Monitor.
- cyproheptadine
cyproheptadine and meperidine both increase sedation. Use Caution/Monitor.
- dantrolene
dantrolene and meperidine both increase sedation. Use Caution/Monitor.
- daridorexant
meperidine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
- darunavir
darunavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
- desflurane
desflurane and meperidine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
- desipramine
meperidine and desipramine both increase sedation. Use Caution/Monitor.
- deutetrabenazine
meperidine and deutetrabenazine both increase sedation. Use Caution/Monitor.
- dexchlorpheniramine
dexchlorpheniramine and meperidine both increase sedation. Use Caution/Monitor.
- dexfenfluramine
meperidine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dexfenfluramine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- dexmedetomidine
dexmedetomidine and meperidine both increase sedation. Use Caution/Monitor.
- dexmethylphenidate
meperidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dextroamphetamine
meperidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.dextroamphetamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- dextroamphetamine transdermal
meperidine, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).
- dextromoramide
dextromoramide and meperidine both increase sedation. Use Caution/Monitor.
- diamorphine
diamorphine and meperidine both increase sedation. Use Caution/Monitor.
- diazepam
diazepam and meperidine both increase sedation. Use Caution/Monitor.
- diethylpropion
meperidine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- difelikefalin
difelikefalin and meperidine both increase sedation. Use Caution/Monitor.
- difenoxin hcl
difenoxin hcl and meperidine both increase sedation. Use Caution/Monitor.
- dihydroergotamine
dihydroergotamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- dihydroergotamine intranasal
dihydroergotamine intranasal and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- dimenhydrinate
dimenhydrinate and meperidine both increase sedation. Use Caution/Monitor.
- diphenhydramine
diphenhydramine and meperidine both increase sedation. Use Caution/Monitor.
- diphenoxylate hcl
diphenoxylate hcl and meperidine both increase sedation. Use Caution/Monitor.
- dipipanone
dipipanone and meperidine both increase sedation. Use Caution/Monitor.
- dobutamine
meperidine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopamine
meperidine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dopexamine
meperidine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- dosulepin
meperidine and dosulepin both increase sedation. Use Caution/Monitor.
- doxepin
meperidine and doxepin both increase sedation. Use Caution/Monitor.
- doxylamine
doxylamine and meperidine both increase sedation. Use Caution/Monitor.
- droperidol
meperidine and droperidol both increase sedation. Use Caution/Monitor.
- efavirenz
efavirenz will decrease the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased toxic metabolite formation.
- eletriptan
eletriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- eltrombopag
eltrombopag increases levels of meperidine by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
- ephedrine
meperidine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine
meperidine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- epinephrine racemic
meperidine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ergotamine
ergotamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- esketamine intranasal
esketamine intranasal, meperidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
- estazolam
estazolam and meperidine both increase sedation. Use Caution/Monitor.
- ethanol
meperidine and ethanol both increase sedation. Use Caution/Monitor.
- etomidate
etomidate and meperidine both increase sedation. Use Caution/Monitor.
- fenfluramine
meperidine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.fenfluramine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- flibanserin
meperidine and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.
- fluphenazine
meperidine and fluphenazine both increase sedation. Use Caution/Monitor.meperidine, fluphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- flurazepam
flurazepam and meperidine both increase sedation. Use Caution/Monitor.
- formoterol
meperidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- fosamprenavir
fosamprenavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
- frovatriptan
frovatriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- gabapentin
gabapentin, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- gabapentin enacarbil
gabapentin enacarbil, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- ganaxolone
meperidine and ganaxolone both increase sedation. Use Caution/Monitor.
- haloperidol
meperidine and haloperidol both increase sedation. Use Caution/Monitor.meperidine, haloperidol. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- hydromorphone
hydromorphone and meperidine both increase sedation. Use Caution/Monitor.
- hydroxyzine
hydroxyzine and meperidine both increase sedation. Use Caution/Monitor.
- iloperidone
meperidine and iloperidone both increase sedation. Use Caution/Monitor.meperidine, iloperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- imipramine
meperidine and imipramine both increase sedation. Use Caution/Monitor.
- indinavir
indinavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
- isoniazid
isoniazid and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- isoproterenol
meperidine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ketamine
ketamine and meperidine both increase sedation. Use Caution/Monitor.
- ketotifen, ophthalmic
meperidine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
- L-tryptophan
L-tryptophan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- lasmiditan
lasmiditan, meperidine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
- lemborexant
lemborexant, meperidine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
- levalbuterol
meperidine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- levorphanol
levorphanol and meperidine both increase sedation. Use Caution/Monitor.
- lisdexamfetamine
meperidine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- lithium
lithium and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- lofepramine
meperidine and lofepramine both increase sedation. Use Caution/Monitor.
- lofexidine
meperidine and lofexidine both increase sedation. Use Caution/Monitor.
- lopinavir
lopinavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity.
- loprazolam
loprazolam and meperidine both increase sedation. Use Caution/Monitor.
- lorazepam
lorazepam and meperidine both increase sedation. Use Caution/Monitor.
- lormetazepam
lormetazepam and meperidine both increase sedation. Use Caution/Monitor.
- loxapine
meperidine and loxapine both increase sedation. Use Caution/Monitor.meperidine, loxapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- loxapine inhaled
meperidine and loxapine inhaled both increase sedation. Use Caution/Monitor.meperidine, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- lsd
lsd and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- lurasidone
lurasidone, meperidine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.meperidine, lurasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- maprotiline
meperidine and maprotiline both increase sedation. Use Caution/Monitor.
- marijuana
meperidine and marijuana both increase sedation. Use Caution/Monitor.
- melatonin
meperidine and melatonin both increase sedation. Use Caution/Monitor.
- meprobamate
meperidine and meprobamate both increase sedation. Use Caution/Monitor.
- metaproterenol
meperidine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- metaxalone
metaxalone and meperidine both increase sedation. Use Caution/Monitor.
- methadone
meperidine and methadone both increase sedation. Use Caution/Monitor.
- methamphetamine
meperidine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- methocarbamol
methocarbamol and meperidine both increase sedation. Use Caution/Monitor.
- methylenedioxymethamphetamine
meperidine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- midazolam
midazolam and meperidine both increase sedation. Use Caution/Monitor.
- midazolam intranasal
midazolam intranasal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of benzodiazepines and opioids increases risk of respiratory depression. Use only in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required.
- midodrine
meperidine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- mirtazapine
meperidine and mirtazapine both increase sedation. Use Caution/Monitor.meperidine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.
- modafinil
meperidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- molindone
meperidine, molindone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- morphine
meperidine and morphine both increase sedation. Use Caution/Monitor.meperidine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.
- motherwort
meperidine and motherwort both increase sedation. Use Caution/Monitor.
- moxonidine
meperidine and moxonidine both increase sedation. Use Caution/Monitor.
- nabilone
meperidine and nabilone both increase sedation. Use Caution/Monitor.
- nalbuphine
meperidine and nalbuphine both increase sedation. Use Caution/Monitor.
- naratriptan
naratriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- nelfinavir
nelfinavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
- nevirapine
nevirapine will decrease the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased toxic metabolite formation.
- norepinephrine
meperidine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- nortriptyline
meperidine and nortriptyline both increase sedation. Use Caution/Monitor.
- olanzapine
meperidine and olanzapine both increase sedation. Use Caution/Monitor.meperidine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- oliceridine
oliceridine, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
- opium tincture
meperidine and opium tincture both increase sedation. Use Caution/Monitor.
- orphenadrine
orphenadrine and meperidine both increase sedation. Use Caution/Monitor.
- oxazepam
oxazepam and meperidine both increase sedation. Use Caution/Monitor.
- oxycodone
meperidine and oxycodone both increase sedation. Use Caution/Monitor.
- oxymorphone
meperidine and oxymorphone both increase sedation. Use Caution/Monitor.
- paliperidone
meperidine and paliperidone both increase sedation. Use Caution/Monitor.meperidine, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- papaveretum
meperidine and papaveretum both increase sedation. Use Caution/Monitor.
- papaverine
meperidine and papaverine both increase sedation. Use Caution/Monitor.
- pegvisomant
meperidine decreases effects of pegvisomant by unknown mechanism. Use Caution/Monitor.
- pentazocine
meperidine and pentazocine both increase sedation. Use Caution/Monitor.meperidine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.
- pentobarbital
pentobarbital and meperidine both increase sedation. Use Caution/Monitor.
- perampanel
perampanel and meperidine both decrease sedation. Use Caution/Monitor.
- perphenazine
meperidine and perphenazine both increase sedation. Use Caution/Monitor.meperidine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- phendimetrazine
meperidine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenobarbital
phenobarbital and meperidine both increase sedation. Use Caution/Monitor.
- phentermine
meperidine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine
meperidine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- phenylephrine PO
meperidine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
- pholcodine
meperidine and pholcodine both increase sedation. Use Caution/Monitor.
- pimavanserin
meperidine, pimavanserin. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- pimozide
meperidine and pimozide both increase sedation. Use Caution/Monitor.meperidine, pimozide. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- pirbuterol
meperidine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- pregabalin
pregabalin, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
- primidone
primidone and meperidine both increase sedation. Use Caution/Monitor.
- prochlorperazine
meperidine and prochlorperazine both increase sedation. Use Caution/Monitor.
- promethazine
promethazine and meperidine both increase sedation. Use Caution/Monitor.
- propofol
propofol and meperidine both increase sedation. Use Caution/Monitor.
- propylhexedrine
meperidine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- protriptyline
meperidine and protriptyline both increase sedation. Use Caution/Monitor.
- quazepam
quazepam and meperidine both increase sedation. Use Caution/Monitor.
- quetiapine
meperidine and quetiapine both increase sedation. Use Caution/Monitor.meperidine, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- ramelteon
meperidine and ramelteon both increase sedation. Use Caution/Monitor.
- remimazolam
remimazolam, meperidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. aCoadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.
- risperidone
meperidine and risperidone both increase sedation. Use Caution/Monitor.meperidine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- ritonavir
ritonavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity.
- rizatriptan
rizatriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- salmeterol
meperidine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- SAMe
meperidine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.
- scullcap
meperidine and scullcap both increase sedation. Use Caution/Monitor.
- secobarbital
secobarbital and meperidine both increase sedation. Use Caution/Monitor.
- sevoflurane
sevoflurane and meperidine both increase sedation. Use Caution/Monitor.
- shepherd's purse
meperidine and shepherd's purse both increase sedation. Use Caution/Monitor.
- stiripentol
stiripentol, meperidine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
- sufentanil
meperidine and sufentanil both increase sedation. Use Caution/Monitor.
- sumatriptan
sumatriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- sumatriptan intranasal
sumatriptan intranasal and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- suvorexant
suvorexant and meperidine both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary
- tapentadol
meperidine and tapentadol both increase sedation. Use Caution/Monitor.meperidine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.
- temazepam
temazepam and meperidine both increase sedation. Use Caution/Monitor.
- terbutaline
meperidine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- thioridazine
meperidine and thioridazine both increase sedation. Use Caution/Monitor.
- thiothixene
meperidine and thiothixene both increase sedation. Use Caution/Monitor.meperidine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- topiramate
meperidine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
- tramadol
meperidine and tramadol both increase sedation. Use Caution/Monitor.meperidine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.
- trazodone
meperidine and trazodone both increase sedation. Use Caution/Monitor.
- triazolam
triazolam and meperidine both increase sedation. Use Caution/Monitor.
- triclofos
triclofos and meperidine both increase sedation. Use Caution/Monitor.
- trifluoperazine
meperidine and trifluoperazine both increase sedation. Use Caution/Monitor.meperidine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- trimipramine
meperidine and trimipramine both increase sedation. Use Caution/Monitor.
- triprolidine
triprolidine and meperidine both increase sedation. Use Caution/Monitor.
- xylometazoline
meperidine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- yohimbine
meperidine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- ziconotide
meperidine and ziconotide both increase sedation. Use Caution/Monitor.
- ziprasidone
meperidine and ziprasidone both increase sedation. Use Caution/Monitor.meperidine, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
- zolmitriptan
zolmitriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- zotepine
meperidine and zotepine both increase sedation. Use Caution/Monitor.
Minor (12)
- brimonidine
brimonidine increases effects of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- bupropion
meperidine increases toxicity of bupropion by unspecified interaction mechanism. Minor/Significance Unknown. May lower seizure threshold; keep bupropion dose as low as possible.
- dextroamphetamine
dextroamphetamine increases effects of meperidine by unspecified interaction mechanism. Minor/Significance Unknown.
- ethotoin
ethotoin decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown.
- eucalyptus
meperidine and eucalyptus both increase sedation. Minor/Significance Unknown.
- fosphenytoin
fosphenytoin decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown.
- lidocaine
lidocaine increases toxicity of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of increased CNS depression.
- metoclopramide
metoclopramide increases effects of meperidine by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Increased CNS depression.metoclopramide increases effects of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
- phenytoin
phenytoin decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown.
- ritonavir
ritonavir decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown. Ritonavir induces the metabolism of meperidine to normeperidine, increasing CNS toxicity.
- sage
meperidine and sage both increase sedation. Minor/Significance Unknown.
- ziconotide
ziconotide, meperidine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Additive decreased GI motility. Additive analgesia. Ziconotide does NOT potentiate opioid induced respiratory depression.
- 5-HTP
Monitor Closely (1)5-HTP and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- albuterol
Monitor Closely (1)meperidine increases and albuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- alfentanil
Monitor Closely (1)alfentanil and meperidine both increase sedation. Use Caution/Monitor.
- almotriptan
Monitor Closely (1)almotriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
- alprazolam
Monitor Closely (1)alprazolam and meperidine both increase sedation. Use Caution/Monitor.
- alvimopan
Contraindicated (1)alvimopan, meperidine. receptor binding competition. Contraindicated. Alvimopan is contraindicated in opioid tolerant patients (ie, those who have taken therapeutic doses of opioids for >7 consecutive days immediately prior to taking alvimopan). Patients recently exposed to opioids are expected to be more sensitive to the effects of alvimopan and therefore may experience abdominal pain, nausea and vomiting, and diarrhea. No significant interaction is expected with concurrent use of opioid analgesics and alvimopan in patients who received opioid analgesics for 7 or fewer consecutive days prior to alvimopan.
- amifampridine
Monitor Closely (1)meperidine increases toxicity of amifampridine by Other (see comment). Modify Therapy/Monitor Closely. Comment: Amifampridine can cause seizures. Coadministration with drugs that lower seizure threshold may increase this risk.
- amitriptyline
Monitor Closely (1)meperidine and amitriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)amitriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- amobarbital
Monitor Closely (1)amobarbital and meperidine both increase sedation. Use Caution/Monitor.
- amoxapine
Monitor Closely (1)meperidine and amoxapine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)amoxapine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
- apomorphine
Monitor Closely (1)meperidine and apomorphine both increase sedation. Use Caution/Monitor.
- arformoterol
Monitor Closely (1)meperidine increases and arformoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
- aripiprazole
Monitor Closely (2)meperidine, aripiprazole. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and aripiprazole both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and armodafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine, asenapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
Monitor Closely (1)atazanavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
Monitor Closely (1)azelastine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)baclofen and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and belladonna and opium both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and benperidol both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)benzhydrocodone/acetaminophen, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (1)meperidine increases and benzphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)brexanolone, meperidine. Either increases toxicity of the other by sedation. Use Caution/Monitor.
Minor (1)brimonidine increases effects of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
Monitor Closely (1)brompheniramine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)buprenorphine and meperidine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
Monitor Closely (1)buprenorphine buccal and meperidine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)buprenorphine buccal, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
Monitor Closely (1)meperidine increases toxicity of buprenorphine, long-acting injection by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of buprenorphine and benzodiazepines or other CNS depressants increases risk of adverse reactions including overdose, respiratory depression, and death. Cessation of benzodiazepines or other CNS depressants is preferred in most cases. In some cases, monitoring at a higher level of care for tapering CNS depressants may be appropriate. In others, gradually tapering a patient off of a prescribed benzodiazepine or other CNS depressant or decreasing to the lowest effective dose may be appropriate.
Minor (1)meperidine increases toxicity of bupropion by unspecified interaction mechanism. Minor/Significance Unknown. May lower seizure threshold; keep bupropion dose as low as possible.
Serious - Use Alternative (1)buspirone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)butabarbital and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)butalbital and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)butorphanol and meperidine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)butorphanol, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
Monitor Closely (1)meperidine increases and caffeine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Serious - Use Alternative (1)meperidine, calcium/magnesium/potassium/sodium oxybates. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (1)carbinoxamine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine, cariprazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
Monitor Closely (1)carisoprodol and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)chloral hydrate and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)chlordiazepoxide and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)chlorpheniramine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and chlorpromazine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)chlorzoxazone and meperidine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)cimetidine increases effects of meperidine by decreasing metabolism. Avoid or Use Alternate Drug.
Monitor Closely (1)cinnarizine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)citalopram and meperidine both increase serotonin levels. Use Caution/Monitor. Combination may increase risk of serotonin syndrome or neuroleptic malignant syndrome-like reactions.Serious - Use Alternative (1)meperidine, citalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)clemastine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine, clobazam. Other (see comment). Use Caution/Monitor. Comment: Concomitant administration can increase the potential for CNS effects (e.g., increased sedation or respiratory depression).
Monitor Closely (1)meperidine and clomipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)clomipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)clonazepam and meperidine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)clonidine, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration enhances CNS depressant effects.
Monitor Closely (1)clorazepate and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, clozapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and clozapine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)cocaine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)codeine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)cyclizine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)cyclobenzaprine and meperidine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)meperidine and cyclobenzaprine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)cyproheptadine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)dantrolene and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and daridorexant both increase sedation. Modify Therapy/Monitor Closely. Coadministration increases risk of CNS depression, which can lead to additive impairment of psychomotor performance and cause daytime impairment.
Monitor Closely (1)darunavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
Monitor Closely (1)desflurane and meperidine both increase sedation. Use Caution/Monitor. Opioids may decrease MAC requirements, less inhalation anesthetic may be required.
Monitor Closely (1)meperidine and desipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)desipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Serious - Use Alternative (1)meperidine and desvenlafaxine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)meperidine and deutetrabenazine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)dexchlorpheniramine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)dexfenfluramine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine increases and dexfenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)dexmedetomidine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and dexmethylphenidate decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (2)dextroamphetamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine increases and dextroamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.Minor (1)dextroamphetamine increases effects of meperidine by unspecified interaction mechanism. Minor/Significance Unknown.
Monitor Closely (1)meperidine, dextroamphetamine transdermal. Either increases effects of the other by serotonin levels. Modify Therapy/Monitor Closely. Initiate with lower doses and monitor for signs and symptoms of serotonin syndrome, particularly during initiation or dosage increase. If serotonin syndrome occurs, discontinue dextroamphetamine transdermal and concomitant serotonergic drug(s).
Serious - Use Alternative (1)dextromethorphan and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)dextromoramide and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)diamorphine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)diazepam and meperidine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)diazepam intranasal, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (1)meperidine increases and diethylpropion decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)difelikefalin and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)difenoxin hcl and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)dihydroergotamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)dihydroergotamine intranasal and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)dimenhydrinate and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)diphenhydramine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)diphenoxylate hcl and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)dipipanone and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and dobutamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and dopamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and dopexamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine and dosulepin both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and doxepin both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)doxepin and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)doxylamine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and droperidol both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)duloxetine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)efavirenz will decrease the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased toxic metabolite formation.
Monitor Closely (1)eletriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)eltrombopag increases levels of meperidine by decreasing metabolism. Use Caution/Monitor. UGT inhibition; significance of interaction unclear.
Serious - Use Alternative (1)meperidine, eluxadoline. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Avoid coadministration with other drugs that cause constipation. Increases risk for constipation related serious adverse reactions. .
Monitor Closely (1)meperidine increases and ephedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and epinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and epinephrine racemic decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)ergotamine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Serious - Use Alternative (2)escitalopram and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
meperidine, escitalopram. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)esketamine intranasal, meperidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely.
Monitor Closely (1)estazolam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and ethanol both increase sedation. Use Caution/Monitor.
Minor (1)ethotoin decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown.
Monitor Closely (1)etomidate and meperidine both increase sedation. Use Caution/Monitor.
Minor (1)meperidine and eucalyptus both increase sedation. Minor/Significance Unknown.
Monitor Closely (2)fenfluramine and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine increases and fenfluramine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Serious - Use Alternative (1)fentanyl, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
Serious - Use Alternative (1)fentanyl intranasal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
Serious - Use Alternative (1)fentanyl transdermal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
Serious - Use Alternative (1)fentanyl transmucosal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration with other CNS depressants, such as skeletal muscle relaxants, may cause respiratory depression, hypotension, profound sedation, coma, and/or death. Consider dose reduction of either or both agents to avoid serious adverse effects. Monitor for hypotension, respiratory depression, and profound sedation.
Monitor Closely (1)meperidine and flibanserin both increase sedation. Modify Therapy/Monitor Closely. Risk for sedation increased if flibanserin is coadministration with other CNS depressants.
Serious - Use Alternative (2)fluoxetine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
meperidine, fluoxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (2)meperidine, fluphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and fluphenazine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)flurazepam and meperidine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)fluvoxamine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)meperidine increases and formoterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)fosamprenavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
Minor (1)fosphenytoin decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown.
Monitor Closely (1)frovatriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)gabapentin, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
Monitor Closely (1)gabapentin enacarbil, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
Monitor Closely (1)meperidine and ganaxolone both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, haloperidol. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and haloperidol both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)hydrocodone, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (1)hydromorphone and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)hydroxyzine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, iloperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and iloperidone both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and imipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)imipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)indinavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
Contraindicated (2)isocarboxazid and meperidine both increase serotonin levels. Contraindicated.
isocarboxazid increases toxicity of meperidine by unknown mechanism. Contraindicated.
Monitor Closely (1)isoniazid and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)meperidine increases and isoproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)ketamine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and ketotifen, ophthalmic both increase sedation. Use Caution/Monitor.
Monitor Closely (1)L-tryptophan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)lasmiditan, meperidine. Either increases effects of the other by sedation. Use Caution/Monitor. Coadministration of lasmiditan and other CNS depressant drugs, including alcohol have not been evaluated in clinical studies. Lasmiditan may cause sedation, as well as other cognitive and/or neuropsychiatric adverse reactions.
Monitor Closely (1)lemborexant, meperidine. Either increases effects of the other by sedation. Modify Therapy/Monitor Closely. Dosage adjustment may be necessary if lemborexant is coadministered with other CNS depressants because of potentially additive effects.
Monitor Closely (1)meperidine increases and levalbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Serious - Use Alternative (1)levomilnacipran and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)levorphanol and meperidine both increase sedation. Use Caution/Monitor.
Minor (1)lidocaine increases toxicity of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Risk of increased CNS depression.
Contraindicated (1)linezolid increases toxicity of meperidine by unknown mechanism. Contraindicated.Serious - Use Alternative (2)linezolid and meperidine both increase serotonin levels. Avoid or Use Alternate Drug. Linezolid may increase serotonin as a result of MAO-A inhibition. If linezolid must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last linezolid dose or after 2 weeks of monitoring, whichever comes first.
meperidine, linezolid. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)meperidine increases and lisdexamfetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)lithium and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)meperidine and lofepramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)lofepramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)meperidine and lofexidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)lopinavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity.
Monitor Closely (1)loprazolam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)lorazepam and meperidine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)meperidine and lorcaserin both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)lormetazepam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, loxapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and loxapine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, loxapine inhaled. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and loxapine inhaled both increase sedation. Use Caution/Monitor.
Monitor Closely (1)lsd and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (2)lurasidone, meperidine. Either increases toxicity of the other by Other (see comment). Use Caution/Monitor. Comment: Potential for increased CNS depressant effects when used concurrently; monitor for increased adverse effects and toxicity.
meperidine, lurasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
Monitor Closely (1)meperidine and maprotiline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)maprotiline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)meperidine and marijuana both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and melatonin both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and meprobamate both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and metaproterenol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)metaxalone and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and methadone both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and methamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)methocarbamol and meperidine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)methylene blue and meperidine both increase serotonin levels. Avoid or Use Alternate Drug. Methylene blue may increase serotonin as a result of MAO-A inhibition. If methylene blue must be administered, discontinue serotonergic drug immediately and monitor for CNS toxicity. Serotonergic therapy may be resumed 24 hours after last methylene blue dose or after 2 weeks of monitoring, whichever comes first.
Monitor Closely (1)meperidine increases and methylenedioxymethamphetamine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Minor (2)metoclopramide increases effects of meperidine by enhancing GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Increased CNS depression.
metoclopramide increases effects of meperidine by pharmacodynamic synergism. Minor/Significance Unknown. Increased CNS depression.
Serious - Use Alternative (1)meperidine, metoclopramide intranasal. Either increases effects of the other by Other (see comment). Avoid or Use Alternate Drug. Comment: Avoid use of metoclopramide intranasal or interacting drug, depending on importance of drug to patient.
Monitor Closely (1)midazolam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)midazolam intranasal, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of benzodiazepines and opioids increases risk of respiratory depression. Use only in patients for whom alternative treatment options are inadequate. Limit dosages and durations to the minimum required.
Monitor Closely (1)meperidine increases and midodrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Serious - Use Alternative (1)milnacipran and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (2)meperidine and mirtazapine both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine and mirtazapine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and modafinil decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine, molindone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
Monitor Closely (2)meperidine and morphine both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine and morphine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and motherwort both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and moxonidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and nabilone both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and nalbuphine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)nalbuphine, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
Monitor Closely (1)naratriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Serious - Use Alternative (1)nefazodone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)nelfinavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity. .
Monitor Closely (1)nevirapine will decrease the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Increased toxic metabolite formation.
Contraindicated (1)nirmatrelvir will increase the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.
Contraindicated (1)nirmatrelvir/ritonavir will increase the level or effect of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Contraindicated. Nirmatrelvir/ritonavir is contraindicated with drugs that are highly dependent on CYP3A for clearance and for which elevated concentrations are associated with serious and/or life-threatening reactions.
Monitor Closely (1)meperidine increases and norepinephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine and nortriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)nortriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (2)meperidine, olanzapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and olanzapine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)oliceridine, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (1)meperidine and opium tincture both increase sedation. Use Caution/Monitor.
Monitor Closely (1)orphenadrine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)oxazepam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and oxycodone both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and oxymorphone both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)ozanimod and meperidine both increase sympathetic (adrenergic) effects, including increased blood pressure and heart rate. Avoid or Use Alternate Drug. Because the active metabolite of ozanimod inhibits MAO-B in vitro, there is a potential for serious adverse reactions, including hypertensive crisis. Therefore, coadministration of ozanimod with drugs that can increase norepinephrine or serotonin is not recommended. Monitor for hypertension with concomitant use.
Monitor Closely (2)meperidine, paliperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and paliperidone both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and papaveretum both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and papaverine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (2)paroxetine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
meperidine, paroxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)meperidine decreases effects of pegvisomant by unknown mechanism. Use Caution/Monitor.
Monitor Closely (2)meperidine and pentazocine both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine and pentazocine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)pentazocine, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Mixed opiate agonist/antagonists usually produce additive sedation with narcotics; however, in narcotic addicted pts., the antagonist activity may provoke withdrawal Sx.
Monitor Closely (1)pentobarbital and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)perampanel and meperidine both decrease sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, perphenazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and perphenazine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and phendimetrazine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Contraindicated (2)phenelzine and meperidine both increase serotonin levels. Contraindicated.
phenelzine increases toxicity of meperidine by unknown mechanism. Contraindicated.
Monitor Closely (1)phenobarbital and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and phentermine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and phenylephrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and phenylephrine PO decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor. .
Minor (1)phenytoin decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown.
Monitor Closely (1)meperidine and pholcodine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine, pimavanserin. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
Monitor Closely (2)meperidine, pimozide. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and pimozide both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and pirbuterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)pregabalin, meperidine. Either increases effects of the other by pharmacodynamic synergism. Modify Therapy/Monitor Closely. Coadministration of CNS depressants can result in serious, life-threatening, and fatal respiratory depression. Use lowest dose possible and monitor for respiratory depression and sedation.
Monitor Closely (1)primidone and meperidine both increase sedation. Use Caution/Monitor.
Contraindicated (2)procarbazine and meperidine both increase serotonin levels. Contraindicated. Combination is contraindicated within 2 weeks of MAOI use.
procarbazine increases toxicity of meperidine by unknown mechanism. Contraindicated. MAOIs may potentiate CNS depression and hypotension. Do not use meperidine within 14 days of MAOI use. .
Monitor Closely (1)meperidine and prochlorperazine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)promethazine and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)propofol and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and propylhexedrine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine and protriptyline both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)protriptyline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)quazepam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, quetiapine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and quetiapine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and ramelteon both increase sedation. Use Caution/Monitor.
Contraindicated (1)rasagiline and meperidine both increase serotonin levels. Contraindicated. Risk of serious, sometimes fatal reactions from serotonin syndrome.
Monitor Closely (1)remimazolam, meperidine. Either increases toxicity of the other by sedation. Modify Therapy/Monitor Closely. aCoadministration may result in profound sedation, respiratory depression, coma, and/or death. Continuously monitor vital signs during sedation and recovery period if coadministered. Carefully titrate remimazolam dose if administered with opioid analgesics and/or sedative/hypnotics.
Monitor Closely (2)meperidine, risperidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and risperidone both increase sedation. Use Caution/Monitor.
Monitor Closely (1)ritonavir increases levels of meperidine by affecting hepatic/intestinal enzyme CYP3A4 metabolism. Use Caution/Monitor. Potential for increased toxicity.Minor (1)ritonavir decreases levels of meperidine by increasing metabolism. Minor/Significance Unknown. Ritonavir induces the metabolism of meperidine to normeperidine, increasing CNS toxicity.
Monitor Closely (1)rizatriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Contraindicated (1)meperidine, safinamide. Either increases toxicity of the other by serotonin levels. Contraindicated. Concomitant use could result in life-threatening serotonin syndrome.
Minor (1)meperidine and sage both increase sedation. Minor/Significance Unknown.
Monitor Closely (1)meperidine increases and salmeterol decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine and SAMe both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)meperidine and scullcap both increase sedation. Use Caution/Monitor.
Monitor Closely (1)secobarbital and meperidine both increase sedation. Use Caution/Monitor.
Contraindicated (1)selegiline and meperidine both increase serotonin levels. Contraindicated. At least 14 days should elapse between discontinuation of selegiline and initiation of analgesic.
Contraindicated (1)selegiline transdermal increases toxicity of meperidine by unknown mechanism. Contraindicated.Serious - Use Alternative (1)selegiline transdermal and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Serious - Use Alternative (1)selinexor, meperidine. unspecified interaction mechanism. Avoid or Use Alternate Drug. Patients treated with selinexor may experience neurological toxicities. Avoid taking selinexor with other medications that may cause dizziness or confusion.
Serious - Use Alternative (2)sertraline and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
meperidine, sertraline. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)sevoflurane and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and shepherd's purse both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)meperidine, sodium oxybate. Either increases effects of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Profound sedation, respiratory depression, coma, and death may result if coadministered. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Serious - Use Alternative (1)meperidine and St John's Wort both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)stiripentol, meperidine. Either increases effects of the other by sedation. Use Caution/Monitor. Concomitant use stiripentol with other CNS depressants, including alcohol, may increase the risk of sedation and somnolence.
Monitor Closely (1)meperidine and sufentanil both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)sufentanil SL, meperidine. Either increases toxicity of the other by pharmacodynamic synergism. Avoid or Use Alternate Drug. Coadministration may result in hypotension, profound sedation, respiratory depression, coma, and death. Reserve concomitant prescribing of these drugs in patients for whom other treatment options are inadequate. Limit dosages and durations to the minimum required. Monitor closely for signs of respiratory depression and sedation.
Monitor Closely (1)sumatriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)sumatriptan intranasal and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)suvorexant and meperidine both increase sedation. Modify Therapy/Monitor Closely. Dosage adjustments of suvorexant and concomitant CNS depressants may be necessary
Monitor Closely (2)meperidine and tapentadol both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine and tapentadol both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)tedizolid, meperidine. Either increases effects of the other by Mechanism: pharmacodynamic synergism. Avoid or Use Alternate Drug. both increase serotonin levels; increased risk of serotonin syndrome.
Monitor Closely (1)temazepam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and terbutaline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine and thioridazine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, thiothixene. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and thiothixene both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)tipranavir, meperidine. Mechanism: unspecified interaction mechanism. Avoid or Use Alternate Drug. Meperidine levels decrease, but metabolite normeperidine levels increase, increasing risk of seizure.
Monitor Closely (1)meperidine and topiramate both increase sedation. Modify Therapy/Monitor Closely.
Monitor Closely (2)meperidine and tramadol both increase serotonin levels. Modify Therapy/Monitor Closely.
meperidine and tramadol both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)tramadol, meperidine. Other (see comment). Avoid or Use Alternate Drug. Comment: Tramadol may reinitiate opiate dependence in pts. previously addicted to other opiates; it may also provoke withdrawal Sx. in pts. who are currently opiate dependent.
Contraindicated (2)tranylcypromine and meperidine both increase serotonin levels. Contraindicated.
tranylcypromine increases toxicity of meperidine by unknown mechanism. Contraindicated.
Monitor Closely (1)meperidine and trazodone both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trazodone and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)triazolam and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)triclofos and meperidine both increase sedation. Use Caution/Monitor.
Monitor Closely (2)meperidine, trifluoperazine. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and trifluoperazine both increase sedation. Use Caution/Monitor.
Monitor Closely (1)meperidine and trimipramine both increase sedation. Use Caution/Monitor.Serious - Use Alternative (1)trimipramine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)triprolidine and meperidine both increase sedation. Use Caution/Monitor.
Serious - Use Alternative (1)valerian and meperidine both increase sedation. Avoid or Use Alternate Drug.
Serious - Use Alternative (1)venlafaxine and meperidine both increase serotonin levels. Avoid or Use Alternate Drug.
Serious - Use Alternative (1)meperidine, vilazodone. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug. Concomitant therapy should be discontinued immediately if signs or symptoms of serotonin syndrome emerge and supportive symptomatic treatment should be initiated. .
Serious - Use Alternative (1)meperidine, vortioxetine. Either increases toxicity of the other by serotonin levels. Avoid or Use Alternate Drug.
Monitor Closely (1)meperidine increases and xylometazoline decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine increases and yohimbine decreases sedation. Effect of interaction is not clear, use caution. Use Caution/Monitor.
Monitor Closely (1)meperidine and ziconotide both increase sedation. Use Caution/Monitor.Minor (1)ziconotide, meperidine. Mechanism: unspecified interaction mechanism. Minor/Significance Unknown. Additive decreased GI motility. Additive analgesia. Ziconotide does NOT potentiate opioid induced respiratory depression.
Monitor Closely (2)meperidine, ziprasidone. unspecified interaction mechanism. Use Caution/Monitor. Serotonin modulators may enhance dopamine blockade, possibly increasing the risk for neuroleptic malignant syndrome. Antipsychotics may enhance serotonergic effect of serotonin modulators, which may result in serotonin syndrome. Monitor for evidence of serotonin toxicity (eg, mental status changes, autonomic instability, and neuromuscular hyperactivity) or neuroleptic malignant syndrome (eg, hyperthermia, muscle rigidity, autonomic dysfunction).
meperidine and ziprasidone both increase sedation. Use Caution/Monitor.
Monitor Closely (1)zolmitriptan and meperidine both increase serotonin levels. Modify Therapy/Monitor Closely.
Monitor Closely (1)meperidine and zotepine both increase sedation. Use Caution/Monitor.