Drug interactions
Alprazolam + Meperidine
Severity: Major
Alprazolam and Meperidine: major interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Opioids combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for this class combination.
What this interaction means in plain words
Alprazolam and Meperidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Alprazolam belongs to Central Nervous System; Meperidine belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A potentiation.
What to do
Avoid concurrent use unless alternatives are inadequate; if needed, use the lowest doses for the shortest duration. Monitor respiratory rate and level of sedation, and counsel patients and carers about warning signs.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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Other interactions of Meperidine
- Alvimopan + Meperidine Contraindicated
Other interactions of Alprazolam
- Alprazolam + Calcium / magnesium / potassium / sodium oxybates Contraindicated
- Alprazolam + Itraconazole Contraindicated
- Alprazolam + Ketoconazole Contraindicated
- Alprazolam + Levoketoconazole Contraindicated
- Alprazolam + Sodium oxybate Contraindicated
- Alfentanil + Alprazolam Major
Frequently asked questions
Can I take Alprazolam with Meperidine?
MediHelp rates the interaction as major. Alprazolam and Meperidine can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Opioids combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death. Regulators have issued boxed warnings for this class combination.
How serious is the interaction between Alprazolam and Meperidine?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid concurrent use unless alternatives are inadequate; if needed, use the lowest doses for the shortest duration. Monitor respiratory rate and level of sedation, and counsel patients and carers about warning signs.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan. The full list is on the Meperidine page.
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