Ability to drive, opioid analgesics ---> SmPC of [dextropropoxyphene] of eMC
The opioid analgesic may cause somnolence, decreased psychic alertness and vertigo
Alprazolam [1], opioid analgesics ---> SmPC of [1] of eMC
The co-administration may enhance the depressive effect on the CNS and an enhancement of the euphoria, leading to an increase in psychic dependence
Amikacine, opioid analgesics
Concurrent administration of amikacin with opioid analgesics may be additive with the respiratory depressant effects
Amisulpride [1], analgesics ---> SmPC of [1] of eMC
Caution is advised when coadministering amisulpride with CNS depressants
Amitriptyline [1], opioid analgesics ---> SmPC of [1] of eMC
There is a possibility of increased sedation with opioid analgesics.
Amphetamine, opioid analgesics
Amfetamines potentiate the analgesic effect of narcotic analgesics.
Analgesics, autologous chondrocyte [2] ---> SmPC of [2] of EMA
Pain relief medicinal products should be used according to the recommendations of the responsible surgeon.
Analgesics, baclofen [2] ---> SmPC of [2] of eMC
The concomitant administration of baclofen and other medications that have a suppressing effect on functions of the central nervous system can enhance the action of baclofen
Analgesics, benzodiazepines
Enhancement of the central depressive effect may occur
Analgesics, bromperidol
The co-administration may cause increased tiredness, drowsiness and respiratory disorders
Analgesics, carbamazepine
The co-administration may promote the neurological adverse effects.
Analgesics, celiprolol
Additive effect
Analgesics, certolizumab pegol [2] ---> SmPC of [2] of EMA
Concomitant treatment with methotrexate, corticosteroids, nonsteroidal anti-inflammatory drugs (NSAIDs) and analgesics showed no effect on the pharmacokinetics of certolizumab pegol based on a population pharmacokinetics analysis.
Analgesics, chlorprothixene
The co-administration of chlorprothixene with CNS depressants may cause strong sedation or respiratory depression
Analgesics, codeine
Possible mutual potentiation of the analgetic effect
Analgesics, dihydrocodeine
Possible mutual potentiation of the analgetic effect
Analgesics, doxepin
The co-administration may enhance the central sedative effect
Analgesics, doxylamine
Antihistaminic agents have additive effects with other CNS depressants
Analgesics, fluphenazine [2] ---> SmPC of [2] of eMC
Phenothiazines may increase the central nervous system depression produced by other CNS depressants
Analgesics, flurazepam [2] ---> SmPC of [2] of eMC
Enhancement of the central depressive effect may occur if benzodiazepines are combined with centrally-acting drugs
Analgesics, gliquidone
The co-administration may enhance the hypoglycemic effect of gliquidone
Analgesics, levosulpiride
The effects of levosulpiride on the gastric motility may be antagonized by analgesic drugs
Analgesics, lofepramine
There is an increased risk of ventricular arrhythmias with lofepramine and analgesics.
Analgesics, midazolam
The co-administration may enhance the analgesic effect
Analgesics, nabilone
Nabilone should be administered with caution to patients who are taking other CNS depressants
Analgesics, narcotine
Noscapine with other CNS depressant drugs may increase the sedation and somnolence of the CNS depressants
Analgesics, nitrazepam
Enhancement of the central depressive effect may occur if benzodiazepines are combined with centrally-acting drugs
Analgesics, nortriptyline
The co-administration of nortriptyline and CNS depressants may increase the depressive effects on the CNS
Analgesics, oxazepam
Enhancement of other CNS depressant drugs
Analgesics, promazine
The concomitant administration of promazine with analgesics may result in potentiation of their effects
Analgesics, propofol
The co-administration may enhance the anesthetic effect and cardiovascular adverse reactions of propofol
Analgesics, rifabutin [2] ---> SmPC of [2] of eMC
Rifabutin has been shown to induce the enzymes of the cytochrome P450 3A subfamily and therefore may affect the pharmacokinetic behaviour of drugs metabolised by the enzymes belonging to this subfamily.
Analgesics, temazepam
Enhancement of the central depressive effect may occur if temazepam is combined with analgesics
Analgesics, tranylcypromine
The effect of CNS depressants can be enhanced by co-administration of tranylcypromine
Analgesics, trazodone
The co-administration may enhance the CNS depressant effect
Antihistamines, opioid analgesics
Antihistamines potentiate the sedative effects of opioid analgesics
Antimuscarinic agents, opioid analgesics ---> SmPC of [methadone] of eMC
Opioid analgesics combined with antimuscarinic agents may produce severe constipation or paralytic ileus
Benperidol, opioid analgesics
The risk of hypotension with opioid analgesics may be increased when benperidol is given concomitantly.
Benzodiazepines, opioid analgesics
Enhancement of the central depressive effect may occur if benzodiazepines are combined with centrally-acting drugs. Enhancement of the euphoria may also occur leading to an increase in psychological dependence.
Bromazepam, opioid analgesics
Enhancement of the central depressive effect may occur and enhancement of the euphoria that may lead to an increased risk in psychic dependence
Brotizolam, opioid analgesics
The co-administration of brotizolam with other central nervous system depressants may enhance the central nervous depressant effect. Enhancement of the euphoria that may lead to an increased risk in psychic dependence
Bupivacaine, central analgesics
Toxic Synergism
Buprenorphine [1], opioid analgesics ---> SmPC of [1] of EMA
This combination increases central nervous system depression.
Buprenorphine/naloxone [1], opioid analgesics ---> SmPC of [1] of EMA
The combination increases the central nervous system depression
Central analgesics, citalopram
Citalopram potentiates the antinociceptive effect of central analgetics
Chlordiazepoxide [1], opioid analgesics ---> SmPC of [1] of eMC
Enhancement of the central depressive effect may occur if chlordiazepoxide is combined with other CNS-depressant drugs. Enhancement of the euphoria may lead to increased psychological dependence.
Cimetidine, opioid analgesics
Cimetidine inhibits metabolism of opioid analgesics.
Cinitapride, opioid analgesics
Decreased effects of cinitapride on the digestive canal
Clebopride, opioid analgesics
Decreased effects of clebopride on the digestive canal
Clemastine, opioid analgesics
Antihistamines potentiate the sedative effects of opioid analgesics
Clobazam [1], opioid analgesics ---> SmPC of [1] of eMC
If clobazam is used concomitantly with narcotic analgesics, possible euphoria may be enhanced; this may lead to increased psychological dependence.
Cloperastine, opioid analgesics
Increased CNS depressant effect
Codeine, opioid analgesics
The co-administration may cause additive depression of CNS
Dantrolene, opioid analgesics
The co-administration of dantrolene and CNS depressants should be avoided due to the adverse reactions of dantrolene may be enhanced (specially the CNS depressant effect and muscle weakness)
Diazepam, opioid analgesics
The co-administration may enhance the depressive effect on the CNS and an enhancement of the euphoria, leading to an increase in psychic dependence
Dimenhydrinate, opioid analgesics
Dimenhydrinate may increase the effects of other CNS depressors and enhance the sedative effects
Dimethindene, opioid analgesics
The sedative effect of CNS depressant drugs may be enhanced
Diphenhydramine, opioid analgesics
Mutual enhancement of CNS-depressant effect
Enalapril/hydrochlorothiazide [1], opioid analgesics ---> SmPC of [1] of eMC
Potentiation of orthostatic hypotension may occur.
Flunitrazepam, narcotic analgesics
The co-administration may enhance the effects, increase euphoria and contribute to an increase in psychical dependence. A respiratory depression cannot be excluded
Flupentixol, opioid analgesics [2] ---> SmPC of [2] of eMC
In common with other antipsychotics, flupentixol enhances the response to other CNS depressants.
Fluphenazine [1], narcotic analgesics ---> SmPC of [1] of eMC
Phenothiazines may increase the central nervous system depression produced by other CNS depressants
Flurazepam [1], narcotic analgesics ---> SmPC of [1] of eMC
Enhancement of the central depressive effect may occur if benzodiazepines are combined with centrally-acting drugs. Enhancement of the euphoria may occur leading to an increase in psychological dependence.
Gentamicin, opioid analgesics
Concurrent administration of gentamicin with opioid analgesics may be additive with the respiratory depressant effects
Haloperidol [1], strong analgesics ---> SmPC of [1] of eMC
In common with all neuroleptics, haloperidol can increase the central nervous system depression produced by other CNS-depressant drugs.
Histamine dihydrochloride [1], opioid analgesics ---> SmPC of [1] of EMA
It has been noted that neuromuscular blocking agents, narcotic analgesics, and various contrast media can induce the release of endogenous histamine; therefore the additive effect should be considered
Hydrochlorothiazide, opioid analgesics ---> SmPC of [enalapril/hydrochlorothiazide] of eMC
Potentiation of orthostatic hypotension may occur.
IMAOs, opioid analgesics ---> SmPC of [alfentanyl] of eMC
The co-administration of opioids with MAO inhibitors may stimulate/inhibit the CNS or induce hypertension or hypotension. The combination is contraindicated or within 2 weeks of discontinuation of MAOI
Isoflurane [1], opioid analgesics ---> SmPC of [1] of eMC
Opioids, benzodiazepines and other sedative agents are associated with respiratory depression, and caution should be exercised when concomitantly administered with isoflurane.
Ketorolac [1], opioid analgesics ---> SmPC of [1] of eMC
Ketorolac has been shown to reduce the need for concomitant opioid analgesia when it is given for the relief of postoperative pain.
Levomepromazine, opioid analgesics
The co-administration of levomepromazine with other central nervous depressants will cause a greater depressant effect on central nervous system
Levomethadone, opioid analgesics
Enhancement of effects and adverse effects, particularly respiratory depression
Lisdexamfetamine [1], opioid analgesics ---> SmPC of [1] of eMC
Amfetamines potentiate the analgesic effect of narcotic analgesics.
Loperamide, opioid analgesics
Concomitant use of loperamide with other opioid analgesics may increase the risk of severe constipation and CNS depression
Loprazolam, opioid analgesics
The co-administration may enhance the depressive effect on the CNS and an enhancement of the euphoria, leading to an increase in psychic dependence
Lorazepam [1], opioid analgesics ---> SmPC of [1] of eMC
Enhancement of the central depressive effect may occur. Enhancement of the euphoria may lead to increased psychological dependence
Lormetazepam, opioid analgesics
An enhancement of the euphoria induced by narcotic analgesics may occur with benzodiazepine use, leading to an increase in psychic dependence.
Medazepam, opioid analgesics
The co-administration of medazepam with other central nervous system depressants may enhance the central nervous depressant effect. Enhancement of the euphoria that may lead to an increased risk in psychic dependence
Melperone, opioid analgesics
The co-administration may enhance the effects until respiratory depression
Methadone, opioid analgesics [2] ---> SmPC of [2] of eMC
The depressant effects of methadone are likely to be enhanced by depressants of the CNS. As well as CNS depression, there may be respiratory depression and/or hypotension.
Methocarbamol, opioid analgesics
Methocarbamol may potentiate the effects of other central nervous system depressants and stimulants
Metoclopramide, opioid analgesics [2] ---> SmPC of [2] of eMC
The action of metoclopramide on the gastrointestinal tract is antagonized by opioid analgesics.
Muscle relaxants, opioid analgesics
Increased effect of muscle relaxant and of respiratory depression
Naltrexone [1], opioid analgesics ---> SmPC of [1] of eMC
Concomitant administration of naltrexone with an opioid-containing medication should be avoided.
Naltrexone/bupropion [1], opioid analgesics ---> SmPC of [1] of EMA
Naltrexone/bupropion is contraindicated in patients currently dependent on chronic opioid or opiate agonist therapy (e.g., methadone), or patients in acute opiate withdrawal
Naphazoline, opioid analgesics
Possible potentiation of the central depression
Narcotic analgesics, procarbazine [2] ---> SmPC of [2] of eMC
Procarbazine may enhance the effect of narcotic analgesics
Narcotic analgesics, triazolam
Increased CNS depressant effect with the co-administration of triazolam and narcotic analgesics may occur. Enhancement of the euphoria may also occur, leading to an increase in psychological dependence
Neuroleptics, opioid analgesics
Potentiation may occur if antipsychotic drugs are combined with CNS depressants
Nitrazepam, opioid analgesics
In the case of narcotic analgesics, enhancement of the euphoria may also occur, leading to an increase in psychological dependence. The elderly require special supervision.
Nortriptyline, opioid analgesics
The co-administration of nortriptyline and CNS depressants may increase the depressive effects on the CNS
Opioid analgesics [1], oxazepam ---> SmPC of [1] of eMC
The co-administration may enhance the CNS depressant effects. Enhancement of analgetic effect and euphoria that may lead to an increased risk in psychic dependence
Opioid analgesics [1], phenelzine ---> SmPC of [1] of eMC
Phenelzine should not be used in combination with narcotic analgesics
Opioid analgesics, oxatomide
The co-administration may increase the CNS depressant effect
Opioid analgesics, pancuronium [2] ---> SmPC of [2] of eMC
Potentiation of the duration of action of pancuronium and the intensity of neuromuscular block.
Opioid analgesics, pholcodine
Pholcodine may enhance the sedative effect of central nervous system depressants
Opioid analgesics, promethazine
The co-administration of promethazine and other central nervous depressants can mutually enhance the effects and adverse reactions (particularly sedation and hypotension)
Opioid analgesics, quazepam
The co-administration may cause a mutual potentiation of the depressor effect on the CNS, enhance the euphoric effect and promote a psychic dependency
Opioid analgesics, risperidone [2] ---> SmPC of [2] of eMC
Risperidone should be used with caution in combination with opioids due to the increased risk of sedation
Opioid analgesics, ritonavir ---> SmPC of [codeine] of eMC
Ritonavir may increase plasma levels of opioid analgesics
Opioid analgesics, sedatives
The co-administration may enhance the depressive respiratory effect of opioid
Opioid analgesics, tapentadol [2] ---> SmPC of [2] of eMC
The co-administration may increase the risk of respiratory depression
Opioid analgesics, temazepam
Enhancement of the euphoria may lead to increased psychological dependence.
Opioid analgesics, thiopental
Opioid analgesics can potentiate the respiratory depressant effect of barbiturate anaesthetics and the dose of anaesthetic may need to be reduced.
Opioid analgesics, tramadol [2] ---> SmPC of [2] of eMC
Concomitant administration of tramadol with other centrally acting drugs may potentiate CNS depressant effects.
Opioid analgesics, tranylcypromine
Avoid concomitant use and until 2 weeks as CNS excitation or depression (hypertension or hypotension) may occur
Opioid analgesics, yohimbine
Yohimbine may increase the analgetic effect of opiate
Opioid analgesics, zaleplon [2] ---> SmPC of [2] of EMA
Enhancement of the central sedation and enhancement of the euphoria may occur leading to an increase in physiological dependence
Opioid analgesics, zolpidem [2] ---> SmPC of [2] of eMC
The co-administration may enhance the depressive effect on the CNS and an enhancement of the euphoria, leading to an increase in psychic dependence
Opioid analgesics, zopiclone [2] ---> SmPC of [2] of eMC
The co-administration may enhance the depressive effect on the CNS and an enhancement of the euphoria, leading to an increase in psychic dependence