Can I take Oxycodone and Quinine together?
Drug interaction guide
Originally published 25 Jan 2026
Meets Patient’s editorial guidelines
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Taking quinine with oxycodone can increase the amount of oxycodone in your blood. This makes the side effects of the painkiller much stronger and more dangerous. You may experience extreme sleepiness, dizziness, confusion, and, most seriously, shallow or slow breathing. There is also a risk of an irregular heartbeat (heart palpitations).
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Why this happens
Quinine can interfere with the way your liver breaks down oxycodone (the active ingredient in Oxypro), leading to a buildup of the painkiller in your system. Additionally, both drugs have the potential to affect the electrical activity of your heart (prolonging the QT interval), and using them together increases this risk.
What you should do
Back to contentsYou should speak to your doctor before taking these two medicines together. If your doctor confirms you must take both, they may need to lower your dose of oxycodone. Seek medical help immediately if you feel unusually sleepy, have trouble breathing, or feel your heart racing or skipping a beat. Avoid driving or operating machinery while taking this combination.
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Important precautions
Back to contentsOpioid dependence/Addiction
Oxycodone is highly addictive. Long-term use can lead to physical dependence and withdrawal symptoms if stopped suddenly.
Respiratory depression
Oxycodone can dangerously slow or stop your breathing, especially when first starting or if the dose is increased. This risk is much higher if taken with alcohol or other sedatives.
Heart rhythm disorders (e.g. Long QT syndrome)
Quinine can cause serious, potentially fatal heart rhythm changes; avoid if you have a history of heart rhythm problems.
Blood disorders (e.g. Thrombocytopenia)
Quinine can cause a sudden, severe drop in platelets which can lead to life-threatening bleeding; stop immediately if you notice unexplained bruising or bleeding.
Tinnitus (ringing in the ears) or hearing loss
Quinine can cause permanent hearing damage or worsen existing tinnitus. Stop taking the medicine immediately if you notice any changes to your hearing or ringing in your ears.
Food and drink warnings
Back to contentsAlcohol
It is best to avoid or strictly limit alcohol when taking oxycodone. Combining alcohol with this medicine significantly increases the risk of dangerous side effects, such as severe drowsiness, breathing difficulties, and a potentially fatal overdose.
It is best to avoid or strictly limit alcohol while taking quinine. Both alcohol and quinine can affect your heart rhythm and cause dizziness; combining them may increase these risks.
Grapefruit juice
Avoid drinking grapefruit juice or eating grapefruit. Grapefruit can increase the levels of these medicines in your blood, making side effects more likely and potentially more severe.
Tonic water
Be aware that tonic water contains small amounts of quinine. While usually safe in small amounts, consuming large quantities of tonic water alongside quinine tablets could increase the risk of side effects like ringing in the ears or blurred vision.
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Using other medicines
Back to contentsTaking multiple medicines? Our Medicines Interaction Checker helps you check whether your prescriptions, over-the-counter medicines, and supplements are safe to take together. Simply search for your medicines to see potential interactions and what to do about them.
Disclaimer
This information is for general educational purposes only and should not be relied upon as a substitute for professional medical advice. Always consult your GP, pharmacist, or another qualified healthcare professional before making decisions about your medications. Individual circumstances may vary, and only a healthcare professional who knows your medical history can provide personalised guidance.
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Taking amitriptyline and oxycodone together can cause extreme sleepiness, dizziness, and severe breathing difficulties. It may also lead to a rare but serious condition called serotonin syndrome, which can cause confusion, sweating, and muscle twitching.
Treatment and medication
Can I take Paracetamol and Tramadol together?
Taking paracetamol and tramadol together is generally safe and is a very common way to manage moderate to severe pain. In fact, many doctors prescribe them together, and some tablets even contain both medicines in one pill. However, because both drugs work to reduce pain, taking them together increases the risk of side effects like drowsiness, dizziness, or feeling sick (nausea). There is also a very small risk of a rare but serious condition called serotonin syndrome, though this is much more likely if you are also taking antidepressants.
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Article history
The information on this page is written and peer reviewed by qualified clinicians.
25 Jan 2026 | Originally published
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