Drug Interaction Report

Hydromorphone Rectal and Thioridazine: Interaction Details

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Thioridazine

No brand names on record
+

Hydromorphone Rectal

available generically
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Aug 8, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close monitoring.
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.

Of 344 documented Hydromorphone Rectal interactions, 329 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased risk of paralytic ileus and an increased risk of respiratory and CNS depression

Interaction Deep Dive

Concomitant use of HYDROmorphone and anticholinergic CNS depressants may result in increased risk of urinary retention or severe constipation, which may lead to paralytic ileus and an increased risk of CNS depression. Reserve the concomitant use of HYDROmorphone and CNS depressants to patients for whom alternatives are inadequate. If concomitant use is necessary, use the lowest dose and shortest duration necessary to achieve treatment goals. Consider using a lower dose of HYDROmorphone or the CNS depressant and closely monitor for urinary retention, severe constipation, sedation, and respiratory depression312. If concomitant use is warranted, consider prescribing naloxone for the emergency treatment of opioid overdose. Inform and educate the patients and caregivers on the signs and symptoms of respiratory depression (including sedation) 1.

Why it happens (mechanism)

Additive effects on gastric motility; additive CNS depression

Literature reports

1 report — tap to read

a) Observational studies have demonstrated that concomitant use of opioid analgesics and benzodiazepines increases the risk of drug-related mortality compared to use of opioid analgesics alone. Because of similar pharmacological properties, it is reasonable to expect similar risk with the concomitant use of other CNS depressant drugs with opioid analgesics 123.

Common questions

Can I take Hydromorphone Rectal and Thioridazine together?

Increased risk of paralytic ileus and an increased risk of respiratory and CNS depression Always confirm with your pharmacist or prescriber before making any change.

How serious is the Hydromorphone Rectal and Thioridazine interaction?

It is rated major. Potentially serious — often needs a change or close monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How strong is the evidence for this interaction?

The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.

Questions for your pharmacist

  • Does my dose of Hydromorphone Rectal or Thioridazine 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 (3)

  1. Product Information: DILAUDID(R) oral tablets, oral solution, hydromorphone HCl oral tablets, oral solution. Rhodes Pharmaceuticals LP (per FDA), Wilson, NC, 2023. DailyMed
  2. Product Information: DILAUDID(R) intravenous injection, intramuscular injection, subcutaneous injection, hydromorphone HCl intravenous injection, intramuscular injection, subcutaneous injection. Fresenius Kabi. (per FDA), Lake Zurich, IL, 2023. DailyMed
  3. Product Information: EXALGO(R) oral extended-release tablets, hydromorphone HCl oral extended-release tablets. SpecGx LLC (per FDA), Webster Groves, MO, 2019. DailyMed
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Beyond drug–drug

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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.