What is Endocet 5/325. How does it compare to Percocet. What are the main uses, side effects, and precautions for Endocet. How should Endocet be taken safely and effectively for pain management.

Understanding Endocet 5/325: Composition and Mechanism of Action

Endocet 5/325 is a prescription medication that combines two active ingredients: acetaminophen (325 mg) and oxycodone (5 mg). This powerful combination is designed to provide effective relief for moderate to severe pain. But how exactly does it work?

Acetaminophen, also known as paracetamol, is a non-opioid analgesic and antipyretic. It works by inhibiting the production of prostaglandins, chemicals in the body that cause pain and inflammation. Oxycodone, on the other hand, is an opioid analgesic that binds to mu-opioid receptors in the central nervous system, altering the perception of pain and emotional response to it.

The synergistic effect of these two components allows Endocet to provide more comprehensive pain relief than either medication alone. This combination approach often allows for lower doses of each individual component, potentially reducing the risk of side effects associated with higher doses of either drug.

Endocet vs. Percocet: Unraveling the Similarities and Differences

Many patients and healthcare providers often wonder about the differences between Endocet and Percocet. In reality, these two medications are virtually identical in terms of their active ingredients and uses. Both contain the same combination of acetaminophen and oxycodone, and both are prescribed for moderate to severe pain management.

The primary difference lies in branding and manufacturing. Endocet is manufactured by Endo Pharmaceuticals, while Percocet is produced by the same company but under a different brand name. Both medications are available in the same strengths: 325 mg of acetaminophen combined with either 2.5 mg, 5 mg, 7.5 mg, or 10 mg of oxycodone.

In terms of efficacy, side effects, and dosing, Endocet and Percocet are interchangeable. The choice between the two often comes down to factors such as insurance coverage, availability, and individual physician preference.

Dosage and Administration: Ensuring Safe and Effective Use of Endocet

Proper dosage and administration of Endocet are crucial for both safety and efficacy. The typical dosage for Endocet 5/325 is one tablet every 6 hours as needed for pain. However, it’s important to note that dosage can vary based on individual factors such as pain severity, medical history, and response to treatment.

• Always follow your doctor’s prescription and instructions carefully.
• Do not exceed the recommended dose or frequency of use.
• Be aware of the maximum daily limit of acetaminophen (4000 mg) to avoid liver damage.
• Take Endocet with or without food, but be consistent to maintain steady drug levels.
• If you miss a dose, take it as soon as you remember unless it’s almost time for your next dose.

Can Endocet be crushed or split? It’s generally not recommended to crush, chew, or split Endocet tablets, as this can alter the drug’s release mechanism and potentially lead to overdose. Always swallow the tablet whole with a full glass of water.

Side Effects and Precautions: What to Watch Out For

While Endocet can be highly effective for pain management, it’s not without potential side effects. Common side effects of Endocet include:

• Constipation
• Nausea and vomiting
• Drowsiness and dizziness
• Headache
• Itching
• Dry mouth

More serious side effects, though less common, can include respiratory depression, severe allergic reactions, and liver damage. It’s crucial to be aware of these potential risks and to seek immediate medical attention if you experience severe side effects.

Are there any precautions to take when using Endocet? Absolutely. Endocet carries a risk of dependence and addiction, especially with prolonged use or in individuals with a history of substance abuse. It’s also important to avoid alcohol while taking Endocet, as the combination can increase the risk of liver damage and other serious side effects.

Drug Interactions: Understanding Potential Risks

Endocet can interact with numerous other medications, potentially altering its effectiveness or increasing the risk of side effects. Some key drug interactions to be aware of include:

1. Other opioid medications
2. Benzodiazepines and other CNS depressants
3. Certain antidepressants (MAOIs, SSRIs, SNRIs)
4. Drugs that affect liver enzymes (CYP3A4 inhibitors or inducers)
5. Muscle relaxants
6. Certain antibiotics and antifungal medications

How can you minimize the risk of drug interactions? Always inform your healthcare provider about all medications, supplements, and herbal products you’re taking. This includes over-the-counter drugs and vitamins. Your doctor can then assess potential interactions and adjust your treatment plan if necessary.

Endocet in Special Populations: Pregnancy, Breastfeeding, and Elderly

The use of Endocet requires special consideration in certain populations. In pregnancy, Endocet is classified as Category C, meaning that while animal studies have shown adverse effects, there isn’t enough human data to fully assess the risk. Use during pregnancy should only occur if the potential benefit justifies the potential risk to the fetus.

For breastfeeding mothers, Endocet is generally not recommended. Both acetaminophen and oxycodone can pass into breast milk, potentially affecting the nursing infant. If pain management is necessary during breastfeeding, alternative treatments should be discussed with a healthcare provider.

In elderly patients, Endocet should be used with caution. Older adults may be more sensitive to the effects of opioids and may require lower doses. Additionally, the risk of side effects such as constipation, confusion, and respiratory depression may be increased in this population.

Alternatives to Endocet: Exploring Other Pain Management Options

While Endocet can be highly effective for pain management, it’s not the only option available. Depending on the type and severity of pain, as well as individual patient factors, alternative treatments may be considered. These can include:

• Non-opioid pain relievers (NSAIDs, COX-2 inhibitors)
• Other opioid medications (morphine, hydrocodone)
• Topical pain relievers
• Non-pharmacological approaches (physical therapy, acupuncture, cognitive behavioral therapy)
• Interventional pain management techniques (nerve blocks, radiofrequency ablation)

How do you determine the best pain management approach? This decision should be made in consultation with your healthcare provider, taking into account factors such as the cause and nature of your pain, your overall health status, and your personal preferences. Remember, effective pain management often involves a multidisciplinary approach combining various treatment modalities.

Responsible Use and Storage of Endocet: Preventing Misuse and Abuse

As a controlled substance with potential for abuse and addiction, responsible use and storage of Endocet are crucial. Here are some important guidelines:

• Take Endocet exactly as prescribed by your doctor.
• Never share your medication with others, even if they have similar symptoms.
• Store Endocet in a secure location, out of reach of children and pets.
• Keep track of the number of tablets to ensure none are missing.
• Dispose of unused medication properly, following FDA guidelines or local take-back programs.

What should you do if you suspect someone is misusing Endocet? If you’re concerned about potential misuse or addiction, it’s important to seek help. Speak with a healthcare provider or contact a substance abuse helpline for guidance and support.

Long-Term Use of Endocet: Benefits and Risks

While Endocet can be effective for short-term pain management, long-term use carries additional considerations and risks. Prolonged use of opioids like oxycodone can lead to tolerance, where higher doses are needed to achieve the same pain-relieving effect. This can increase the risk of side effects and dependence.

Long-term use of acetaminophen, even at recommended doses, may increase the risk of liver damage in some individuals. Regular liver function monitoring may be necessary for patients on long-term Endocet therapy.

Are there strategies to mitigate the risks of long-term Endocet use? Yes, several approaches can help:

• Regular reassessment of pain management needs
• Incorporating non-pharmacological pain management techniques
• Periodic attempts at dose reduction or drug holidays
• Close monitoring for signs of tolerance or dependence
• Regular liver function tests

It’s crucial to maintain open communication with your healthcare provider about the effectiveness of your pain management regimen and any concerns you may have about long-term medication use.

Endocet and Mental Health: Understanding the Connection

The relationship between chronic pain, opioid use, and mental health is complex and bidirectional. Chronic pain can contribute to the development or exacerbation of mental health conditions such as depression and anxiety. Conversely, these mental health conditions can influence pain perception and coping abilities.

Opioids like the oxycodone in Endocet can have mood-altering effects, potentially providing temporary relief from symptoms of depression or anxiety. However, long-term use can sometimes worsen these conditions or lead to the development of new mental health issues.

How can patients balance pain management and mental health when using Endocet? A comprehensive approach is key:

• Regular mental health screening for patients on long-term opioid therapy
• Incorporation of mental health support into pain management plans
• Consideration of non-opioid treatments for patients with a history of mental health disorders
• Open communication about mood changes or new mental health symptoms

Remember, effective pain management should address both physical and psychological aspects of pain. Your healthcare provider can help develop a treatment plan that addresses all aspects of your health and well-being.

Endocet in the Context of the Opioid Crisis

The use of opioid medications like Endocet must be considered within the broader context of the ongoing opioid crisis. While these medications play a crucial role in pain management for many patients, their potential for misuse and addiction has contributed to a significant public health problem.

Healthcare providers are increasingly adopting more cautious prescribing practices for opioids, including:

• Thorough patient screening before prescribing opioids
• Use of prescription drug monitoring programs
• Implementation of opioid contracts or treatment agreements
• Regular reassessment of the need for continued opioid therapy
• Education on proper use, storage, and disposal of opioid medications

What role do patients play in addressing the opioid crisis? Patients can contribute by using opioids responsibly, being honest with their healthcare providers about their pain and medication use, and properly storing and disposing of unused medications. It’s also important to be aware of the signs of opioid misuse or addiction and to seek help if concerns arise.

Future Directions in Pain Management: Beyond Endocet

As our understanding of pain mechanisms and treatment options evolves, the landscape of pain management continues to change. Research is ongoing into new approaches that may provide effective pain relief with fewer risks than traditional opioid medications.

Some promising areas of research include:

• Novel non-opioid analgesics targeting specific pain pathways
• Advanced drug delivery systems for more targeted pain relief
• Gene therapy approaches to pain management
• Personalized medicine strategies based on genetic factors
• Integration of artificial intelligence in pain assessment and treatment planning

How might these developments impact the use of medications like Endocet in the future? While opioid medications are likely to remain an important tool in pain management for the foreseeable future, these new approaches may provide additional options for patients and healthcare providers. This could potentially reduce reliance on opioids and help mitigate some of the risks associated with their use.

As research progresses, it’s important for both patients and healthcare providers to stay informed about new developments in pain management. This knowledge can help inform treatment decisions and ensure that patients receive the most appropriate and effective care for their individual needs.

Endocet vs Percocet: Main Differences and Similarities

Endocet and Percocet are two brand names for the combination of acetaminophen and oxycodone. This combination medication is often prescribed for moderate to severe pain that is not relieved with other therapies.

Acetaminophen is a nonsteroidal anti-inflammatory drug (NSAID) that treats pain and inflammation by decreasing the production of prostaglandins. Oxycodone is an opioid that binds to mu receptors in the brain. This combination produces a strong analgesic effects to relieve pain from injury, surgery, and other conditions.

Endocet

Endocet comes in strengths of 325 mg-2.5 mg, 325 mg-5 mg, 325 mg-7.5 mg, and 325 mg-10 mg of acetaminophen and oxycodone. The usual dose of Endocet is given every 6 hours as needed for pain. Common side effects of Endocet include constipation, nausea, and somnolence.

Percocet

Percocet is available in strengths of 325 mg-2.5 mg, 325 mg-5 mg, 325 mg-7.5 mg, and 325 mg-10 mg of acetaminophen and oxycodone. Percocet can be taken every 6 hours as needed for pain depending on a doctor’s prescription. Common side effects of Percocet include constipation, nausea, and somnolence.

Endocet vs Percocet Side by Side Comparison

Endocet and Percocet are identical medications used for pain. Their features can be found in the table below.

Summary

Endocet and Percocet contain the same active ingredients, acetaminophen and oxycodone. As a potent opioid combination, Endocet and Percocet can help relieve moderate to severe pain.

Both Endocet and Percocet come in similar dosage forms. They can both be taken multiple times throughout the day as needed for pain. However, the maximum recommended daily dose of acetaminophen is 4000 mg. This is because acetaminophen can cause liver damage at high doses.

Acetaminophen and oxycodone can cause side effects such as constipation and nausea. As a Schedule II drug, this combination also has a high risk for abuse and dependence. Those who abuse acetaminophen and oxycodone report feelings of euphoria which can lead to addiction.

It is important to discuss these medications with a doctor. This information should be reviewed with a doctor to determine the best treatment option for you.

Endocet – Uses, Side Effects, Interactions

How does this medication work? What will it do for me?

This combination product contains two medications: oxycodone and acetaminophen. Acetaminophen belongs to the group of medications called analgesics (pain relievers) and antipyretics (fever reducers). Oxycodone belongs to the group of medications called narcotic analgesics. Oxycodone – acetaminophen is used to relieve moderate to moderately severe pain, including conditions associated with fever. This medication should only be used when other non-narcotic pain medications are not effective or tolerated.

This medication may be available under multiple brand names and/or in several different forms. Any specific brand name of this medication may not be available in all of the forms or approved for all of the conditions discussed here. As well, some forms of this medication may not be used for all of the conditions discussed here.

Your doctor may have suggested this medication for conditions other than those listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

What form(s) does this medication come in?

Endocet is no longer being manufactured for sale in Canada. For brands that may still be available, search under oxycodone – acetaminophen. This article is being kept available for reference purposes only. If you are using this medication, speak with your doctor or pharmacist for information about your treatment options.

How should I use this medication?

The dosage varies according to each individual and can be affected by the severity of the pain as well as each person’s response to the medication.

The usual recommended adult dose of oxycodone – acetaminophen (each tablet contains 5 mg oxycodone and 325 mg acetaminophen) is one tablet every 6 hours as needed for pain. This medication should be used at the lowest dose that provides pain relief for a maximum of 7 days.

Swallow the tablets whole with fluid. Do not cut, break, crush, chew, or dissolve the tablets. Doing so can result in dangerous adverse events, including death.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

This medication may be habit-forming if taken for long periods of time. Do not stop taking this medication without talking with your doctor. If this medication is stopped suddenly, you may experience withdrawal symptoms such as anxiety, sweating, trouble sleeping, shakiness, nausea, tremors, diarrhea, or hallucinations. If you plan on stopping the medication, your doctor may want you to reduce the dose gradually to reduce the severity of withdrawal effects.

It is important to take this medication exactly as prescribed by your doctor. If your doctor has told you to take this medication on a regular basis and you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

Who should NOT take this medication?

Do not take this medication if you:

• are allergic to oxycodone, acetaminophen, or to any of the ingredients of the medication
• have severely decreased liver function or active liver disease
• have a seizure disorder
• have pre-existing respiratory depression
• have status asthmaticus (unresponsive asthma)
• are pregnant, breast-feeding, or in labour
• are taking or have taken (within the last 14 days) MAO inhibitors (e. g., phenelzine, tranylcypromine)
• have a head injury
• have a brain tumour
• have acute alcoholism
• have mild pain that can be controlled by occasional use of pain medications
• have acute asthma or other obstructive airway diseases (e.g., chronic bronchitis, emphysema)
• have cor pulmonale (heart failure caused by chronic high blood pressure in the arteries of the lungs)
• have delirium tremens (e.g., confusion, diarrhea, shaking, fever, hallucinations, disorientation) associated with alcohol withdrawal
• have increased cerebral spinal fluid pressure
• have increased levels of carbon dioxide in the blood
• have an abdominal condition that may require immediate surgery (e.g., appendicitis, pancreatitis)
• have or may have bowel or digestive system problems (e.g., paralytic ileus), or may have a blockage in the digestive system

What side effects are possible with this medication?

Many medications can cause side effects.  A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• decreased ability or interest in sexual activity
• decreased coordination
• dizziness
• drowsiness
• headache
• itching
• lightheadedness or feeling faint
• nausea
• sweating
• vomiting
• weakness

Although most of the side effects listed below don’t happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• blurred or double vision or other changes in vision
• difficulty sleeping
• dizziness when rising from a lying down or sitting position
• dry mouth
• fast, slow, or pounding heartbeat
• loss of appetite
• symptoms of withdrawal (e.g., nausea, vomiting, diarrhea, anxiety, shivering, cold and clammy skin, body aches, loss of appetite, sweating)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• convulsions (seizures)
• signs of a bowel blockage (abdominal pain, nausea, severe constipation)signs of a serious allergic reaction (e.g., abdominal cramps, difficulty breathing, nausea and vomiting, or swelling of the face and throat)
• signs of breathing problems (e.g., shallow, irregular breathing, or slow or troubled breathing)
• signs of severe skin reactions (e. g., blistering, peeling, a rash covering a large area of the body, a rash that spreads quickly, or a rash combined with fever or discomfort)
• symptoms of overdose (e.g., cold, clammy skin, abnormally slow or weak breathing, severe dizziness, confusion, slow heartbeat, or extreme drowsiness)
• symptoms of serotonin syndrome (e.g., confusion, fast heartbeat, hallucinations, restlessness, shaking, shivering, sudden jerking of muscles, sweating)

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

HEALTH CANADA ADVISORY

February 19, 2021

Health Canada has issued new restrictions concerning the use of acetaminophen. To read the full Health Canada Advisory, visit Health Canada’s web site at https://recalls-rappels.canada.ca/en/alert-recall/unintentional-exposure-young-children-adult-acetaminophen-tablets-may-pose-serious

Abdominal conditions: Oxycodone may make the diagnosis of abdominal conditions more difficult or it may worsen these conditions. People with abdominal conditions such as inflammatory or obstructive bowel disease, acute cholecystitis, or pancreatitis should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Accidental use: When oxycodone – acetaminophen is used by anyone other than the person for whom it was prescribed, the effects of the medication may be fatal. Children are especially at risk. Keep this medication out of sight and reach of children.

Alcohol and other medications that cause drowsiness: People taking this medication should not combine it with alcohol, and should avoid combining it with other medications that cause drowsiness or slow down your breathing (e.g., antidepressants, sleeping pills, anxiety medications). Doing so can cause additive drowsiness and reduced breathing, as well as other side effects, which can be dangerous and possibly fatal.

Breathing: Oxycodone can suppress breathing. People at risk for breathing difficulties, such as asthma, should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Dependence and withdrawal: This medication contains oxycodone. Physical dependence, psychological dependence, and abuse have occurred with the use of oxycodone. People with a history of past or current substance use problems may be at greater risk of developing abuse or addiction while taking this medication. Abuse is not a problem with people who require this medication for pain relief. If this medication is stopped suddenly, you may experience withdrawal symptoms such as anxiety, sweating, trouble sleeping, shaking, pain, nausea, tremors, diarrhea, and hallucinations. If you have been taking this medication for a while, it should be stopped gradually as directed by your doctor.

Drowsiness/reduced alertness: This medication may cause drowsiness. Do not drive, operate machinery, or perform other potentially hazardous tasks until you have determined how this medication affects you.

Head injury: People with head injuries or increased pressure in the head may have a higher risk of experiencing side effects (breathing problems) or worsening of their condition while taking this medication. These people should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney function: Decreased kidney function can cause this medication to build up in the body, causing side effects. If you have kidney disease or reduced kidney function, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver function: Acetaminophen can cause severe and potentially fatal liver damage. Acetaminophen is a common ingredient in many non-prescription medications for colds and flu, pain, arthritis, and fever. Check the product label on all the medications you are taking to make sure that you are not exceeding the recommended dose of acetaminophen. An overdose of acetaminophen can lead to potentially fatal liver damage.

Contact your doctor immediately if you experience symptoms of liver problems such as fatigue, feeling unwell, loss of appetite, nausea, yellowing of the skin or whites of the eyes, dark urine, pale stools, abdominal pain or swelling, and itchy skin.

Low blood pressure: This medication can make low blood pressure worse or cause low blood pressure, which may be severe. If you experience severe dizziness, especially when standing from a lying or sitting position, contact your doctor.

Other medical conditions: People about to undergo surgery of the biliary tract should use caution while taking oxycodone as it may worsen their condition. Oxycodone will worsen the effects of acute alcohol intoxication and delirium tremens.

As well, people with an irregular heart rhythm, low blood pressure, low thyroid (hypothyroidism), Addison’s disease, benign prostatic hypertrophy (enlarged prostate), urethral stricture, decreased function of the adrenal glands, or porphyria should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Seizures: This medication may cause seizures, especially when higher doses are used or when taken with other medications that may increase the risk of seizures. The risk of seizures is also higher for people with epilepsy, a history of seizures, or who are at risk of seizures (e.g., people with head trauma).

Serotonin Syndrome: Although rare, severe reactions are possible when oxycodone is combined with other medications that act on serotonin, such as tricyclic antidepressants and serotonin reuptake inhibitors, medications used to treat depression. These combinations should be avoided if possible. Symptoms of a reaction may include muscle rigidity and spasms, difficulty moving, changes in mental state including delirium and agitation. Coma and death are possible. 

If you are taking antidepressants, discuss with your doctor how this medication may affect your medical condition, how your medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. Infants born to mothers who have taken oxycodone during pregnancy have been born with signs of narcotic withdrawal. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking oxycodone and acetaminophen, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Children: The safety and effectiveness of using full-strength oxycodone – acetaminophen have not been established for children under 18 years of age.

Seniors: Seniors who take this medication may be more likely to experience side effects or worsening of preexisting medical conditions.

What other drugs could interact with this medication?

There may be an interaction between oxycodone – acetaminophen and any of the following:

• acetazolamide
• aclidinium
• alcohol
• amphetamines (e. g., dextroamphetamine, lisdexamfetamine)
• anesthetics
• antihistamines (e.g., bilastine, cetirizine, dimenhydrinate, diphenhydramine, hydroxyzine, rupatadine)
• antipsychotics (e.g., haloperidol, quetiapine, olanzapine, perphenazine, risperidone, thioridazine)
• aprepitant
• atropine
• azelastine
• “azole” antifungal medications (e.g., fluconazole, itraconazole, ketoconazole)
• barbiturates (e.g., butalbital, phenobarbital)
• benzodiazepines (e.g., alprazolam, diazepam, lorazepam)
• benztropine
• bosentan
• brimonidine
• buprenorphine
• bupropion
• buspirone
• butorphanol
• cannabis
• chloral hydrate
• clidinium
• cobicistat
• conivaptan
• diuretics (e.g., amiloride, bumetanide, furosemide, hydrochlorothiazide)
• desmopressin
• diltiazem
• diphenoxylate
• disopyramide
• domperidone
• dronedarone
• efavirenz
• etravirine
• eluxadoline
• entacapone
• enzalutamide
• eplerenone
• esketamine
• fesoterodine
• flibanserin
• flunarizine
• glycopyrrolate
• grapefruit juice
• HIV protease inhibitors (e. g., darunavir, indinavir, lopinavir, ritonavir saquinavir)
• ipratropium
• isoniazid
• kava kava
• lemborexant
• letermovir
• lidocaine
• linezolid
• lithium
• macrolide antibiotics (e.g., clarithromycin, erythromycin,)
• methylene blue
• metoclopramide
• mifepristone
• mirabegron
• mirtazapine
• modafinil
• monoamine oxidase inhibitors (MAOIs; e.g., tranylcypromine, phenelzine, moclobemide, rasagiline, selegiline)
• muscle relaxants (e.g., baclofen, methocarbamol, orphenadrine)
• naltrexone
• other narcotic analgesics (e.g., fentanyl, codeine, morphine)
• oxybutynin
• pegvisomant
• phenylephrine
• pomalidomide
• pregabalin
• protein kinase inhibitors (e.g., ceritinib, crizotinib, dabrafenib, dasatinib, imatinib, nilotinib)
• quinidine
• rifabutin
• rifampin
• ropinirole
• rotigotine
• St. John’s wort
• scopolamine
• seizure medications (e.g., carbamazepine, felbamate, lamotrigine, levetiracetam, phenytoin, primidone, topiramate, vigabatrin)
• selective serotonin reuptake inhibitors (SSRIs; e.g., citalopram, fluoxetine, sertraline)
• serotonin/norepinephrine reuptake inhibitors (e.g., desvenlafaxine, duloxetine, venlafaxine)
• sodium oxybate
• somatostatin analogues (e.g., lanreotide, octreotide, pasireotide)
• tetrabenazine
• tiotropium
• tizanidine
• trazodone
• tricyclic antidepressants (e.g., amitriptyline, desipramine, imipramine)
• tryptophan
• valerian
• verapamil
• warfarin
• zolpidem
• zopiclone

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.