Skip to main content

Drug Interactions between nalbuphine and Olinvyk

This report displays the potential drug interactions for the following 2 drugs:

Edit list (add/remove drugs)

Interactions between your drugs

Major

nalbuphine oliceridine

Applies to: nalbuphine and Olinvyk (oliceridine)

GENERALLY AVOID: Concomitant use of opioids with other central nervous system (CNS) depressants including mixed agonist-antagonist or partial agonist opioids may result in profound sedation, respiratory depression, coma, and death. The risk of hypotension may also be increased. On the other hand, mixed agonist-antagonist or partial agonist opioids can reduce the pharmacologic effects of other opioid agonists. Reduced efficacy or withdrawal symptoms may occur in patients maintained on their opioid regimen following the addition of a mixed agonist-antagonist or partial agonist opioid.

MANAGEMENT: The use of opioids in conjunction with other CNS depressants including mixed agonist-antagonist or partial agonist opioids should generally be avoided unless alternative treatment options are inadequate. If coadministration is necessary (e.g., when initiating a switch from one opioid to the other), the dosage and duration of each drug should be limited to the minimum required to achieve desired clinical effect, and patients should be closely monitored for signs and symptoms of CNS and respiratory depression. Additional caution is advisable when a mixed agonist-antagonist or partial agonist opioid is added to an existing opioid regimen, as there may be an increased risk of withdrawal symptoms (e.g., restlessness, insomnia, sweating, lacrimation, or rhinorrhea) following initiation of the mixed agonist-antagonist or partial agonist opioid. A dosage adjustment for one or both drugs may be required.

References

  1. Moldenhauer CC, Roach GW, Finlayson DC, et al. (1985) "Nalbuphine antagonism of ventilatory depression following high-dose fentanyl anesthesia." Anesthesiology, 62, p. 647-50
  2. Gilman AG, eds., Nies AS, Rall TW, Taylor P (1990) "Goodman and Gilman's the Pharmacological Basis of Therapeutics." New York, NY: Pergamon Press Inc.
  3. Strain EC, Preston KL, Liebson IA, Bigelow GE (1993) "Precipitated withdrawal by pentazocine in methadone-maintained volunteers." J Pharmacol Exp Ther, 267, p. 624-34
  4. (2001) "Product Information. Nubain (nalbuphine)." Endo Laboratories LLC
  5. (2001) "Product Information. Buprenex (buprenorphine)." Reckitt and Colman Pharmaceuticals Inc
  6. (2001) "Product Information. Talwin NX (pentazocine)." Sanofi Winthrop Pharmaceuticals
  7. (2001) "Product Information. Stadol (butorphanol)." Allscrips Pharmaceutical Company
  8. (2001) "Product Information. Dalgan (dezocine)." Astra-Zeneca Pharmaceuticals
  9. (2002) "Product Information. Suboxone (buprenorphine-naloxone)." Reckitt and Colman Pharmaceuticals Inc
  10. (2002) "Product Information. Subutex (buprenorphine)." Reckitt and Colman Pharmaceuticals Inc
  11. (2010) "Product Information. Butrans (buprenorphine)." Purdue Pharma LP
View all 11 references

Switch to consumer interaction data

Drug and food interactions

Major

oliceridine food

Applies to: Olinvyk (oliceridine)

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including oliceridine. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

GENERALLY AVOID: Grapefruit or grapefruit juice may increase the plasma concentrations of oliceridine by inhibiting the CYP450 3A4-mediated metabolism of oliceridine, although the interaction has not been studied. In general, the effect of grapefruit juice is concentration-, dose- and preparation-dependent, and can vary widely among brands. Certain preparations of grapefruit juice (e.g., high dose, double strength) have sometimes demonstrated potent inhibition of CYP450 3A4, while other preparations (e.g., low dose, single strength) have typically demonstrated moderate inhibition. Pharmacokinetic interactions involving grapefruit juice are also subject to a high degree of interpatient variability, thus the extent to which a given patient may be affected is difficult to predict.

MANAGEMENT: Patients should not consume alcoholic beverages or use drug products that contain alcohol during treatment with oliceridine. Any history of alcohol or illicit drug use should be considered when prescribing oliceridine, and therapy initiated at a lower dosage if necessary. Patients should be closely monitored for signs and symptoms of sedation, respiratory depression, and hypotension. Due to a high degree of interpatient variability with respect to grapefruit juice interactions, patients treated with oliceridine should preferably avoid the consumption of grapefruit and grapefruit juice.

References

  1. (2020) "Product Information. Olinvyk (oliceridine)." Trevena Inc

Switch to consumer interaction data

Moderate

nalbuphine food

Applies to: nalbuphine

GENERALLY AVOID: Ethanol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics. Concomitant use may result in additive CNS depression and impairment of judgment, thinking, and psychomotor skills. In more severe cases, hypotension, respiratory depression, profound sedation, coma, or even death may occur.

MANAGEMENT: Concomitant use of opioid analgesics with ethanol should be avoided.

References

  1. Linnoila M, Hakkinen S (1974) "Effects of diazepam and codeine, alone and in combination with alcohol, on simulated driving." Clin Pharmacol Ther, 15, p. 368-73
  2. Sturner WQ, Garriott JC (1973) "Deaths involving propoxyphene: a study of 41 cases over a two-year period." JAMA, 223, p. 1125-30
  3. Girre C, Hirschhorn M, Bertaux L, et al. (1991) "Enhancement of propoxyphene bioavailability by ethanol: relation to psychomotor and cognitive function in healthy volunteers." Eur J Clin Pharmacol, 41, p. 147-52
  4. Levine B, Saady J, Fierro M, Valentour J (1984) "A hydromorphone and ethanol fatality." J Forensic Sci, 29, p. 655-9
  5. Sellers EM, Hamilton CA, Kaplan HL, Degani NC, Foltz RL (1985) "Pharmacokinetic interaction of propoxyphene with ethanol." Br J Clin Pharmacol, 19, p. 398-401
  6. Carson DJ (1977) "Fatal dextropropoxyphene poisoning in Northern Ireland. Review of 30 cases." Lancet, 1, p. 894-7
  7. Rosser WW (1980) "The interaction of propoxyphene with other drugs." Can Med Assoc J, 122, p. 149-50
  8. Edwards C, Gard PR, Handley SL, Hunter M, Whittington RM (1982) "Distalgesic and ethanol-impaired function." Lancet, 2, p. 384
  9. Kiplinger GF, Sokol G, Rodda BE (1974) "Effect of combined alcohol and propoxyphene on human performance." Arch Int Pharmacodyn Ther, 212, p. 175-80
View all 9 references

Switch to consumer interaction data

Therapeutic duplication warnings

No warnings were found for your selected drugs.

Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.

See also

Report options

Loading...
QR code containing a link to this page

Drug Interaction Classification

These classifications are only a guideline. The relevance of a particular drug interaction to a specific individual is difficult to determine. Always consult your healthcare provider before starting or stopping any medication.
Major Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit.
Moderate Moderately clinically significant. Usually avoid combinations; use it only under special circumstances.
Minor Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan.
Unknown No interaction information available.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer