Talk:Hydromorphone

"I'm fairly new to editing so I'm not exactly sure how to change interaction information, but the grapefruit interaction is inaccurate. Unlike most opioids, hydromorphone is metabolized not by liver enzymes but primarily by glucuronidation.

"Although hydromorphone has these notable characteristics in common with morphine and other opioids, the manner in which hydromorphone is metabolized is an important differentiating characteristic. Hydromorphone is largely metabolized in first-pass phase II metabolism by glucuronidation. Unlike other opioids, such as oxycodone and codeine, hydromorphone is not metabolized by the cytochrome P-450 enzyme pathway, thus reducing the potential for significant drug–drug interactions"

This means that CYP3A4/2D6 inhibitors should have no effect on levels of hydromorphone in the blood, including grapefruit juice of course. What could be important to mention though would be the fact that renal impairment can have a substantial effect on both peak levels and half-life.

Gregory, T. B. (2013). Hydromorphone: Evolving to Meet the Challenges of Today’s Health Care Environment. Clinical Therapeutics, 35(12), 2007–2027. doi:10.1016/j.clinthera.2013.09.027 

Here's the source for this info, thanks for the help with formatting! You guys are a great community.