Hydrocodone and Abametapir: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jun 30, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Abametapir
No brand names on recordHydrocodone
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Abametapir is a lotion used to treat head lice. Even though you only put it on your scalp, a little gets into your body, and it can slow down a liver enzyme (called CYP3A4) that helps break down many medicines, including hydrocodone, your pain medicine.
When that enzyme is slowed, hydrocodone can build up in your body. That could mean stronger effects like extra drowsiness, dizziness, or slowed breathing. This is based on how the drugs work rather than on lots of real-world reports, but it is taken seriously. The good news is this is easy to plan around, so talk with your pharmacist or doctor about the timing of these two.
Mechanism: Abametapir inhibits CYP3A4, reducing metabolism of the CYP3A4 substrate hydrocodone and increasing its systemic exposure (AUC/Cmax). Hydrocodone is active in its own right (not a prodrug dependent on this pathway for benefit), so inhibition increases opioid effect and toxicity risk.
Direction: Increased hydrocodone exposure, potentiated CNS and respiratory depression.
Onset: Rapid. Evidence: Theoretical. Severity: Major.
- Avoid CYP3A4 substrates, including hydrocodone, for 2 weeks after abametapir application.
- If concurrent use is unavoidable, avoid abametapir.
- If exposure occurs, monitor for sedation, respiratory depression, and other opioid effects.
What happens
Increased exposure of CYP3A4 substrate
Interaction Deep Dive
For 2 weeks following the application of abametapir, refrain from using CYP3A4 substrates. When avoiding these substrates is not possible, then abametapir itself should be avoided 1.
Why it happens (mechanism)
Inhibition of CYP3A4-mediated metabolism by abametapir
How to manage this interaction
The main strategy here is timing and avoidance. The interaction can last for about 2 weeks after the lice lotion is used.
- Keep taking your medicines only as prescribed. Do not stop or change either one on your own.
- Tell your pharmacist and prescriber that you take hydrocodone before using abametapir so they can plan the timing.
- Your care team may hold off on the abametapir treatment, or space these apart, and monitor you more closely if both must be used.
- Watch for and report extra drowsiness, confusion, or slowed or shallow breathing.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Hydrocodone and Abametapir together?
Abametapir can slow the breakdown of hydrocodone, raising the risk of opioid effects like heavy sedation and slowed breathing for up to 2 weeks. Talk to your pharmacist or doctor about timing before combining them. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Hydrocodone and Abametapir interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "rapid". Effects can appear quickly, often within about 24 hours of combining the drugs.
How is the Hydrocodone and Abametapir interaction managed?
The main strategy here is timing and avoidance. The interaction can last for about 2 weeks after the lice lotion is used. Keep taking your medicines only as prescribed. Do not stop or change either one on your own. Tell your pharmacist and prescriber that you take hydrocodone before using abametapir so they can plan the timing. Your care team may hold off on the abametapir treatment, or space thes… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
From our Q&A
Real reader questions about these medications, each personally answered by our pharmacist:
Questions for your pharmacist
- Does my dose of Hydrocodone or Abametapir need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (1)
- Product Information: XEGLYZE(TM) topical lotion, abametapir topical lotion. Dr Reddy’s Laboratories Inc (per FDA), Princeton, NJ, 2020. DailyMed
Keep reading about Abametapir
Keep reading about Hydrocodone
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