Selected Extended-Release Opioids/Alcohol 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:

Severe. These medicines may interact and cause very harmful effects and are usually not taken together. Contact your healthcare professional (e.g. doctor or pharmacist) for more information.

How the interaction occurs:

Your pain medicine is designed to release your medicine throughout the day. Alcohol may speed up how quickly the medicine is released and may result in all of the medicine being released at one time.

What might happen:

The amount of pain medicine in your blood may increase rapidly. This may cause a fatal overdose.

What you should do about this interaction:

Let your healthcare professionals (e.g. doctor or pharmacist) know that you are taking Avinza, Nucynta, Opana or Zohydro. You should not consume any alcoholic beverages or use any medicines (prescription or over-the-counter) that contain alcohol. Your healthcare professional can help you find an alternative medicine that does not contain alcohol.If any slow, troubled, shallow, or labored breathing; severe drowsiness or inability to awaken; unusually slow heartbeat, cold/clammy skin or a seizure occurs, get medical help right away.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.

  • 1.Avinza (morphine extended-release capsules) US prescribing information. Ligand Pharmaceuticals Incorporated April, 2014.
  • 2.Opana ER (oxymorphone hydrochloride) US prescribing information. Endo Pharmaceuticals, Inc. October, 2019.
  • 3.Nucynta ER (tapentadol) US prescribing information. Janssen Pharmaceuticals December, 2016.
  • 4.Zohydro ER (hydrocodone bitarate) US prescribing information. Zogenix Inc. October, 2019.
  • 5.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: https://www.fda.gov/drugs/drug-safety-and-availability/fda-recommends-heal th-care-professionals-discuss-naloxone-all-patients-when-prescribing-opioi d-pain July 23, 2020.

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.