Taking Hydrocodone With Lexapro

In our latest question and answer, the pharmacist discusses whether or not there is a drug interaction between hydrocodone and Lexapro (escitalopram).

Apr 25, 2018

Brandon asked

I take Lexapro for anxiety & I just had some teeth pulled & was prescribed hydrocodone . Is it safe to take them together or should I spread them out?


Taking hydrocodone and Lexapro together increases the risk for developing a major and potentially serious side effect known as serotonin syndrome. Although the combination of opioids, like hydrocodone, and SSRIs, like Lexapro, are used frequently, caution is advised.

Serotonin Syndrome

Serotonin syndrome is the name given to a certain group of symptoms that can occur with the use of multiple serotonergic drugs. The symptoms can range from mild to severe and include but are not limited to the following:

  • Hyperthermia/heavy sweating
  • Shaking/tremors
  • Nausea
  • Vomiting
  • Agitation
  • Delirium
  • Confusion
  • Rapid heart rate
FDA Safety Statement

In fact, the FDA released a safety communication in 2016, warning both practitioners and patients about the possibility of serotonin syndrome with the combined use of opioids and serotonergic drugs. Although their use together isn't contraindicated, it is important to be aware of any signs of serotonin syndrome and seek medication attention immediately should any manifest.

Taking Hydrocodone With Lexapro

Taking your doses of hydrocodone and Lexapro at different times of the day does not affect the potential for serotonin syndrome to develop as Lexapro has a relatively long half-life and will last in the body for more than 24 hours.

As mentioned above, the use of an SSRI like Lexapro and hydrocodone is a fairly common combination of drugs. However, if you develop symptoms that you think may be related to serotonin syndrome, you should contact a health care professional immediately.

Lexapro Information

Lexapro (escitalopram) is a selective serotonin re-uptake inhibitor (SSRI). It is used most commonly for the treatment of depression and anxiety disorders. Each new dose of Lexapro takes around 12 weeks to reach full effect although effects may be noticed in as little as two weeks.

Lexapro may be taken without regard to food but is best when taken either in the morning or in the evening; whichever is better tolerated or fits better with other medication you may be taking. Common side effects of Lexapro include but are not limited to:

  • Drowsiness
  • Nausea
  • Dizziness
  • Diarrhea
  • Insomnia
Hydrocodone Information

Hydrocodone is a opiate agonist that is indicated for the treatment of moderate to severe pain. Hydrocodone may be given with food or milk to help prevent GI irritation. You should titrate the dose of hydrocodone slowly, utilizing the lowest effective dose to minimize the possibility of side effects. Common side effects associated with taking hydrocodone include but are not limited to:

  • Constipation
  • Drowsiness
  • Nausea
  • Euphoria

Ready for a more personal experience with your meds?