Sometimes you don’t want a story. You want a list. You’re standing in the kitchen with a new prescription in one hand and your oxycodone in the other, and you’d like to know which medicines deserve a second look. This page is built for that moment: a quick-reference directory of common medications that interact with oxycodone, arranged alphabetically by drug group, with one line each on why it matters and where to read more.
For the explanation of how and why these interactions happen, see our companion guide to medications that interact with oxycodone. This page is a lookup tool, not medical advice. Your pharmacist can check your exact medicines against each other.
How to Use This List
- Find the drug group that matches your new medicine.
- Read the “What to know” line and the caution tag.
- Follow the link if you want the full story.
- Confirm with your pharmacist or prescriber before combining anything.
The tags mean this: Avoid unless directed signals a serious, often boxed-warning-level concern. Ask first signals a real but manageable interaction. Usually lower concern means no well-known direct interaction, though your pharmacist should still know about it. These tags are teaching shorthand, not a clinical rating.
The A–Z Directory
A: Alcohol, Antibiotics, Antifungals, Antihistamines, Antipsychotics
| Group | Examples | What to know | Tag |
|---|---|---|---|
| Alcohol | Beer, wine, spirits, alcohol-containing liquids | A central nervous system depressant. The oxycodone label warns of profound sedation, respiratory depression, coma and death with such depressants. Read more | Avoid unless directed |
| Antibiotics: macrolides | Clarithromycin, erythromycin | CYP3A4 inhibitors that can raise oxycodone levels. Read more | Ask first |
| Antibiotics: penicillins, cephalosporins | Amoxicillin, cephalexin | No well-known enzyme interaction; watch for stomach upset. | Usually lower concern |
| Antibiotics: others | Rifampin, linezolid | Rifampin can lower oxycodone levels; linezolid has MAO-inhibiting activity. | Ask first |
| Antifungals | Fluconazole, ketoconazole, itraconazole, voriconazole | Can block liver enzymes. Read more | Ask first |
| Antihistamines: sedating | Diphenhydramine (Benadryl), doxylamine, hydroxyzine, chlorpheniramine | Add drowsiness, constipation and confusion. Read more | Ask first |
| Antihistamines: less sedating | Loratadine, fexofenadine, cetirizine | Often manageable; cetirizine still makes some people sleepy. Read more | Usually lower concern |
| Antipsychotics | Quetiapine, olanzapine | Sedation and low blood pressure. | Ask first |
B: Benzodiazepines, Blood Pressure Medicines, Buprenorphine
| Group | Examples | What to know | Tag |
|---|---|---|---|
| Benzodiazepines | Alprazolam, lorazepam, diazepam, clonazepam | Boxed warning for profound sedation, respiratory depression, coma and death. Read more | Avoid unless directed |
| Blood pressure medicines | Diuretics, beta-blockers, ACE inhibitors, others | Opioids can lower blood pressure or cause dizziness on standing, which may add to the effect of these drugs. Read more | Ask first |
| Buprenorphine and similar partial agonists | Buprenorphine, butorphanol, pentazocine, nalbuphine | May reduce oxycodone’s effect or trigger withdrawal. Prescriber-managed only. | Avoid unless directed |
C–D: Cannabis, Carisoprodol, Decongestants
| Group | Examples | What to know | Tag |
|---|---|---|---|
| Cannabis and cannabinoid products | THC and CBD products | Can add drowsiness and impair coordination. Tell your prescriber about use. | Ask first |
| Carisoprodol | Soma | A controlled muscle relaxer with misuse potential. Read more | Avoid unless directed |
| Decongestants | Pseudoephedrine, phenylephrine | Can raise heart rate and blood pressure, which conflicts with opioid effects. Read more | Ask first |
G–H: Gabapentinoids, Grapefruit, HIV Medicines
| Group | Examples | What to know | Tag |
|---|---|---|---|
| Gabapentinoids | Gabapentin, pregabalin | Can add to breathing depression, especially in older adults or those with lung disease. Related reading | Ask first |
| Grapefruit and grapefruit juice | Fresh fruit, juice | Can affect CYP3A4. Read more | Ask first |
| HIV protease inhibitors | Ritonavir and boosted combinations | Strong CYP3A4 effects; prescriber-managed. | Ask first |
M–N: MAO Inhibitors, Melatonin, Muscle Relaxers, NSAIDs
| Group | Examples | What to know | Tag |
|---|---|---|---|
| MAO inhibitors | Selegiline, phenelzine, tranylcypromine | Serious reactions are possible. Oxycodone labeling advises avoiding use with or shortly after MAOIs. | Avoid unless directed |
| Melatonin | Supplements | No well-known enzyme interaction, but evidence is limited and grogginess is possible. Read more | Usually lower concern |
| Muscle relaxers | Cyclobenzaprine, methocarbamol, tizanidine, baclofen | Add sedation, dizziness and fall risk. Read more | Ask first |
| NSAIDs | Ibuprofen, naproxen, aspirin | Not sedating, but consider stomach and kidney effects. Ibuprofen, naproxen, aspirin | Ask first |
O–S: Other Opioids, Seizure Medicines, Sleep Medications, SSRIs and SNRIs, St. John’s Wort
| Group | Examples | What to know | Tag |
|---|---|---|---|
| Other opioids | Tramadol, hydrocodone, codeine, morphine | Overlapping effects and overdose risk. Compare with tramadol | Avoid unless directed |
| Seizure medicines (enzyme inducers) | Carbamazepine, phenytoin | Can lower oxycodone levels. | Ask first |
| Sleep medications | Zolpidem, eszopiclone, temazepam, trazodone | Added sedation and breathing concerns. Read more | Avoid unless directed (benzodiazepines, Z-drugs); ask first (others) |
| SSRIs and SNRIs | Sertraline, fluoxetine, venlafaxine, duloxetine | Serotonin syndrome risk; some also affect liver enzymes. Never stop on your own. | Ask first |
| St. John’s wort | Herbal supplement | Alters liver enzyme activity and may lower oxycodone levels. | Ask first |
T: Tricyclic Antidepressants, Triptans, Tylenol
| Group | Examples | What to know | Tag |
|---|---|---|---|
| Tricyclic antidepressants | Amitriptyline, nortriptyline | Sedation and serotonin-related concerns. | Ask first |
| Triptans | Sumatriptan, rizatriptan | Serotonin-related caution. See oxycodone and migraine. | Ask first |
| Acetaminophen (Tylenol) | Tylenol, Percocet-type products, “PM” and cold products | Watch for duplicate acetaminophen. Tylenol, acetaminophen | Ask first |
The Three Patterns Behind the List
Nearly every entry above falls into one of three buckets. Stacked sedation covers alcohol, benzodiazepines, sleep drugs, sedating antihistamines and muscle relaxers. Liver enzyme changes cover antibiotics, antifungals, HIV medicines, grapefruit, rifampin, seizure drugs and St. John’s wort. Serotonin effects cover SSRIs, SNRIs, tricyclics, triptans and MAOIs. If a medicine falls into none of these buckets, it is less likely to be a major concern, though your pharmacist should still check. For the biology, see how the liver processes oxycodone.
What Happens When Levels Go Too High or Too Low
Too High
Possible signs include heavy drowsiness, confusion, nausea, very small pupils and slow or shallow breathing. See signs your oxycodone dose may be too high.
Too Low
If an enzyme inducer lowers oxycodone levels, pain may return sooner or feel poorly controlled, and withdrawal-like symptoms are possible. See signs your oxycodone dose may be too low.
Is Your Name Missing From the List? Check These
- Your drug is not on the list, but it makes you sleepy: treat it like a sedative.
- It is a new antibiotic, antifungal or antiviral: ask about liver enzymes.
- It affects mood or migraines: ask about serotonin.
- It is a supplement, tea or “natural” product: ask anyway.
Who Should Be Extra Careful
Older adults, people with liver or kidney disease, and people with sleep apnea, asthma or COPD face higher risk from many combinations. See oxycodone and elderly patients, liver disease, kidney disease and sleep apnea.
Where to Verify
The official prescribing information for each product is listed on DailyMed, and a neutral overview of oxycodone is available at MedlinePlus. The FDA’s explanation of the opioid and benzodiazepine warning is in its drug safety communication.
Emergency Signs
Call emergency services for slow or shallow breathing, inability to wake, blue or gray lips or severe confusion. In the United States, Poison Control is 1-800-222-1222 at poison.org.
Medical disclaimer: This article is for general educational purposes and is not medical advice, diagnosis or treatment. It does not replace consultation with a licensed healthcare professional who knows your history. Never start, stop or change a medication without guidance from your doctor or pharmacist.