Skip to Content

Hydrocodone / ibuprofen and Alcohol / Food Interactions

There are 3 alcohol/food/lifestyle interactions with hydrocodone / ibuprofen which include:

Major

HYDROcodone ↔ food

Major Food Interaction

Consumer information for this interaction is not currently available.

GENERALLY AVOID: Alcohol may potentiate the central nervous system (CNS) depressant effects of opioid analgesics including hydrocodone. 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: Consumption of alcohol while taking some sustained-release formulations of hydrocodone may cause rapid release of the drug, resulting in high systemic levels of hydrocodone that may be potentially lethal. Alcohol apparently can disrupt the release mechanism of some sustained-release formulations. In study subjects, the rate of absorption of hydrocodone from an extended-release formulation was found to be affected by coadministration with 40% alcohol in the fasted state, as demonstrated by an average 2.4-fold (up to 3.9-fold in one subject) increase in hydrocodone peak plasma concentration and a decrease in the time to peak concentration. Alcohol also increased the extent of absorption by an average of 1.2-fold (up to 1.7-fold in one subject).

GENERALLY AVOID: Grapefruit juice may increase the plasma concentrations of hydrocodone. The proposed mechanism is inhibition of CYP450 3A4-mediated metabolism of hydrocodone by certain compounds present in grapefruit. Increased hydrocodone concentrations could conceivably increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.

MANAGEMENT: Patients taking sustained-release formulations of hydrocodone should not consume alcohol or use medications that contain alcohol. In general, potent narcotics such as hydrocodone should not be combined with alcohol. Patients should also avoid consumption of grapefruit or grapefruit juice during treatment with hydrocodone.

References

  1. "Product Information. Zohydro ER (HYDROcodone)." Zogenix, Inc, San Diego, CA.
Major

High Blood Pressure (Hypertension)

Severe Potential Hazard, Moderate plausibility

NSAIDs - fluid retention

Fluid retention and edema have been reported in association with the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Therapy with NSAIDs should be administered cautiously in patients with preexisting fluid retention, hypertension, or a history of heart failure. Blood pressure and cardiovascular status should be monitored closely during the initiation of NSAID treatment and throughout the course of therapy.

References

  1. Heerdink ER, Leufkens HG, Herings RM, Ottervanger JP, Stricker BH, Bakker A "NSAIDs associated with increased risk of congestive heart failure in elderly patients taking diuretics." Arch Intern Med 158 (1998): 1108-12
  2. Agnholt J, Andreasen F "The effect of ibuprofen therapy on water and electrolyte balance." Acta Med Scand 212 (1982): 65-9
  3. "Product Information. Orudis (ketoprofen)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  4. "Product Information. Celebrex (celecoxib)." Searle, Chicago, IL.
  5. "Product Information. Lodine (etodolac)." Wyeth-Ayerst Laboratories, Philadelphia, PA.
  6. Lewis RV, Toner JM, Jackson PR, Ramsay LE "Effects of indomethacin and sulindac on blood pressure of hypertensive patients." Br Med J 292 (1986): 934-5
  7. "Product Information. Daypro (oxaprozin)." Searle, Skokie, IL.
  8. Johnson AG, Nguyen TV, Day RO "Do nonsteroidal anti-inflammatory drugs affect blood pressure? A meta-analysis." Ann Intern Med 121 (1994): 289-300
  9. "Product Information. Naprosyn (naproxen)." Syntex Laboratories Inc, Palo Alto, CA.
  10. Van Den Ouweland FA, Gribnau FW, Meyboom RH "Congestive heart failure due to nonsteroidal anti-inflammatory drugs in the elderly." Age Ageing 17 (1988): 8-16
  11. "Product Information. Nalfon (fenoprofen)." Xspire Pharma, Ridgeland, MS.
  12. "Product Information. Anaprox (naproxen)." Roche Laboratories, Nutley, NJ.
  13. "Product Information. Mobic (meloxicam)" Boehringer-Ingelheim, Ridgefield, CT.
  14. "Product Information. Feldene (piroxicam)." Pfizer US Pharmaceuticals, New York, NY.
  15. "Product Information. Ansaid (flurbiprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  16. "Product Information. Motrin (ibuprofen)." Pharmacia and Upjohn, Kalamazoo, MI.
  17. Willkens RF "Worldwide clinical safety experience with diclofenac." Semin Arthritis Rheum 2 Suppl 1 (1985): 105-10
  18. Heynen G "Toleration and safety of piroxicam." Eur J Rheumatol Inflamm 8 (1987): 86-93
  19. "Product Information. Clinoril (sulindac)." Merck & Co, Inc, West Point, PA.
  20. Gurwitz JH, Everitt DE, Monane M, et al "The impact of ibuprofen on the efficacy of antihypertensive treatment with hydrochlorothiazide in elderly persons." J Gerontol A Biol Sci Med Sci 51 (1996): m74-9
  21. "Product Information. Indocin (indomethacin)." Merck & Co, Inc, West Point, PA.
  22. "Product Information. Vioxx (rofecoxib)." Merck & Co, Inc, West Point, PA.
  23. Easton PA, Koval A "Hypertensive reaction with sulindac." Can Med Assoc J 122 (1980): 1273-4
  24. Brooks CD, Linet OI, Schellenberg D, Turner LF, Defesche CL, Teoh KW, Johnson JH, Assenzo JR "Clinical safety of flurbiprofen." J Clin Pharmacol 30 (1990): 342-51
  25. Petersson I, Nilsson G, Hansson B-G, Hedner T "Water intoxication associated with non-steroidal anti-inflammatory drug therapy." Acta Med Scand 221 (1987): 221-3
  26. Buckley MM, Brogden RN "Ketorolac. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential." Drugs 39 (1990): 86-109
  27. "Product Information. Tolectin (tolmetin)." McNeil Pharmaceutical, Raritan, NJ.
  28. "Product Information. Relafen (nabumetone)." SmithKline Beecham, Philadelphia, PA.
  29. "Product Information. Bextra (valdecoxib)." Pharmacia Corporation, Peapack, NJ.
View all 29 references
Moderate

High Blood Pressure (Hypertension)

Moderate Potential Hazard, Moderate plausibility

NSAIDs - hypertension

NSAIDs including topicals can lead to the onset of new hypertension or worsening of preexisting hypertension, either of which can contribute to the increased incidence of cardiovascular events. Blood pressure should be monitored closely during NSAID therapy and throughout the course of therapy.

hydrocodone / ibuprofen drug Interactions

There are 1170 drug interactions with hydrocodone / ibuprofen

hydrocodone / ibuprofen disease Interactions

There are 29 disease interactions with hydrocodone / ibuprofen which include:

Drug Interaction Classification

The classifications below are a general guideline only. It is difficult to determine the relevance of a particular drug interaction to any individual given the large number of variables.
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 information available.

Do not stop taking any medications without consulting your healthcare provider.

Disclaimer: Every effort has been made to ensure that the information provided by Multum is accurate, up-to-date and complete, but no guarantee is made to that effect. In addition, the drug information contained herein may be time sensitive and should not be utilized as a reference resource beyond the date hereof. This material does not endorse drugs, diagnose patients, or recommend therapy. Multum's information is a reference resource designed as supplement to, and not a substitute for, the expertise, skill, knowledge, and judgement of healthcare practitioners in patient care. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective, or appropriate for any given patient. Multum Information Services, Inc. does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. Copyright 2000-2018 Multum Information Services, Inc. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse, or pharmacist.

Hide