Efavirenz and Hydrocodone and chlorpheniramine interaction

Efavirenz and Hydrocodone and chlorpheniramine: both prescribing labels flag this combination with the strongest language, such as a contraindication, a boxed warning, or an instruction to avoid it.

Major

Do not combine without a prescriber's guidance. The label language below is the strongest FDA uses.

What the FDA labels say

From the Hydrocodone and chlorpheniramine (Hydrocodone Polistirex and Chlorpheniramine Polistirex extended-release) label · effective 2025-06-26

Major

Cytochrome P450 3A4 Interaction The concomitant use of Hydrocodone Polistirex and Chlorpheniramine Polistirex with all cytochrome P450 3A4 inhibitors may result in an increase in hydrocodone plasma concentrations, which could increase or prolong adverse drug effects and may cause potentially fatal respiratory depression.

Boxed warningby drug classView label on DailyMed
Major

In addition, discontinuation of a concomitantly used cytochrome P450 3A4 inducer may result in an increase in hydrocodone plasma concentration.

Boxed warningby drug classView label on DailyMed
Major

Avoid the use of Hydrocodone Polistirex and Chlorpheniramine Polistirex in patients taking a CYP3A4 inhibitor or inducer [ see Warnings and Precautions (5.7) , Drug Interactions (7.2 , 7.3) ].

Boxed warningby drug classView label on DailyMed
Major

Concomitant use with CYP3A4 inhibitors (or discontinuation of CYP3A4 inducers) can result in a fatal overdose of hydrocodone.

Boxed warningby drug classView label on DailyMed
Major

Avoid the use of Hydrocodone Polistirex and Chlorpheniramine Polistirex in patients taking CYP3A4 inhibitors or inducers.

Boxed warningby drug classView label on DailyMed

From the Efavirenz label · effective 2024-03-31

Moderate

Prophylaxis with appropriate antihistamines before initiating therapy with efavirenz in pediatric patients should be considered.

Warnings and precautionsby drug classView label on DailyMed
Moderate

Narcotic analgesic: Methadone ↓ methadone * Monitor for signs of methadone withdrawal and increase methadone dose if required to alleviate withdrawal symptoms. * The interaction between efavirenz and the drug was evaluated in a clinical study.

Drug interactionsby drug classView label on DailyMed
Minor

Appropriate antihistamines and/or corticosteroids may improve the tolerability and hasten the resolution of rash.

Warnings and precautionsby drug classView label on DailyMed

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Not medical advice. Interaction Checker quotes FDA label text and NIH fact sheets. Whether an interaction matters for you depends on doses, timing, kidney and liver function, and other conditions. Confirm with a pharmacist or prescriber.