Selected Opioid Analgesics/Cimetidine Interactions

This information is generalized and not intended as specific medical advice. Consult your healthcare professional before taking or discontinuing any drug or commencing any course of treatment.

Medical warning:

Moderate. These medicines may cause some risk when taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Cimetidine may slow down how quickly your body processes some pain medicines.

What might happen:

The amount of pain medicine in your blood may increase, which may increase your risk of nausea, vomiting, constipation, lightheadedness, dizziness, and excessive drowsiness. Your pain medicine may cause very serious side effects including shortness of breath or difficulty breathing.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know right away that you are taking these medicines together. Your doctor may want to adjust the dose of your pain medicine.Ask your doctor or pharmacist if you should have naloxone available to treat opioid overdose. Teach your family or household members about the signs of an opioid overdose and how to treat it. If someone has overdosed and has serious symptoms such as passing out or trouble breathing, give them naloxone if available, then call 911. If the person is awake and has no symptoms, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include: slow/shallow breathing, slow heartbeat, coma.Your healthcare professionals may already be aware of this interaction and may be monitoring you for it. Do not start, stop, or change the dosage of any medicine before checking with them first.

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  • 5.Stadol (butorphanol tartrate) US prescribing information. Bristol-Myers Squibb April, 2002.
  • 6.Zohydro ER (hydrocodone bitarate) US prescribing information. Zogenix Inc. October, 2019.
  • 7.Demerol (meperidine hydrochloride) US prescribing information. Validus Pharmaceuticals LLC. December, 2023.
  • 8.Nubain (nalbuphine hydrochloride) US prescribing information. Endo Pharmaceuticals Inc. October, 2019.
  • 9.OxyContin (oxycodone hydrochloride) US prescribing information. Perdue Pharma L.P. October, 2021.
  • 10.Opana ER (oxymorphone hydrochloride) US prescribing information. Endo Pharmaceuticals, Inc. October, 2019.
  • 11.Dilaudid (hydromorphone) US prescribing information. Fresenius Kabi USA, LLC October, 2019.
  • 12.Apadaz (benzhydrocodone and acetaminophen) US prescribing information. KemPharm, Inc.. December, 2023.
  • 13.Actiq (fentanyl citrate) Australian prescribing information. Orphan Australia Pty Ltd. November 2, 2002.
  • 14.Duragesic (fentanyl) US prescribing information. Janssen Pharmaceuticals, Inc. October, 2019.
  • 15.Dsuvia (sufentanil) sublingual tablet US prescribing information. AcelRx Pharmaceuticals, Inc. December, 2023.
  • 16.This information is based on an extract from the Certara Drug Interaction Database (DIDB) Platform, Copyright Certara 1999-2023..
  • 17.USFood and Drug Administration. FDA Drug Safety Communication: FDA updates prescribing information for all opioid pain medicines to provide additional guidance for safe use. Available at: ibing-information-all-opioid-pain-medicines-provide-additional-guidance-s afe-use?utm_medium=email&utm_source=govdelivery April 13, 2023.
  • 18.USFood and Drug Administration. FDA Drug Safety Communication: FDA recommends health care professionals discuss naloxone with all patients when prescribing opioid pain relievers or medicines to treat opioid use disorder. Available at: lth-care-professionals-discuss-naloxone-all-patients-when-prescribing-opi oid-pain July 23, 2020.
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  • 30.Guay DR, Meatherall RC, Chalmers JL, Grahame GR. Cimetidine alters pethidine disposition in man. Br J Clin Pharmacol 1984 Dec;18(6):907-14.

Selected from data included with permission and copyrighted by First Databank, Inc. This copyrighted material has been downloaded from a licensed data provider and is not for distribution, except as may be authorized by the applicable terms of use.

CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. A healthcare professional should be consulted before taking any drug, changing any diet or commencing or discontinuing any course of treatment.