Promethazine, phenylephrine, and codeine vs Mixed Agonist / Antagonist Opioids

Interacting Drugs
Promethazine, phenylephrine, and codeine
vs
Mixed Agonist / Antagonist Opioids
Security Level
Moderate, Consider therapy modification
Mechanism
Mixed Agonist / Antagonist Opioids: May diminish the analgesic effect of Analgesics (Opioid).
Management
Seek alternatives to mixed agonist/antagonist opioids in patients receiving pure opioid agonists, and monitor for symptoms of therapeutic failure/high dose requirements (or withdrawal in opioid-dependent patients) if patients receive these combinations.

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Post Review about Promethazine, phenylephrine, and codeine vs Mixed Agonist / Antagonist Opioids


Other Interactions of Promethazine, phenylephrine, and codeine
Interaction
Moderate, Consider therapy modification Promethazine, phenylephrine, and codeine vs CYP2B6 Inhibitors (Strong)
Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs CYP2B6 Inhibitors (Moderate)
Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs CYP2B6 Inducers (Strong)
Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs CNS Depressants
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Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs Atomoxetine
Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs Antipsychotic Agents (Phenothiazines)
Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs Anticholinergics
Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs Amphetamines
Minor, Monitor Therapy Promethazine, phenylephrine, and codeine vs Ammonium Chloride
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Other Interactions of Mixed Agonist / Antagonist Opioids
Interaction
Moderate, Consider therapy modification Oxycodone and acetaminophen vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Butalbital compound and codeine vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Hydrocodone and pseudoephedrine vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Acetaminophen and codeine vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Remifentanil vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Dihydrocodeine, chlorpheniramine, and phenylephrine vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Oxycodone and ibuprofen vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Morphine sulfate and naltrexone vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Hydrocodone and homatropine vs Mixed Agonist / Antagonist Opioids
Moderate, Consider therapy modification Triprolidine, pseudoephedrine, and codeine vs Mixed Agonist / Antagonist Opioids
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