Drug interactions
Benzhydrocodone / acetaminophen + Diphenoxylate-atropine
Severity: Major
Benzhydrocodone / acetaminophen and Diphenoxylate-atropine: 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
Benzhydrocodone is an opioid prodrug of hydrocodone. Combining it with diphenoxylate, another opioid, increases risk of profound sedation and respiratory depression, and the atropine component may worsen constipation.
What this interaction means in plain words
Benzhydrocodone / acetaminophen and Diphenoxylate-atropine 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.
Why it happens
Additive mu-opioid receptor-mediated CNS and respiratory depression.
What to do
Avoid unnecessary co-prescription; if both are needed, use the lowest doses and shortest duration and monitor for sedation and respiratory depression.
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 Diphenoxylate-atropine
- Diphenoxylate-atropine + Isocarboxazid Contraindicated
- Diphenoxylate-atropine + Phenelzine Contraindicated
- Diphenoxylate-atropine + Tranylcypromine Contraindicated
- Alfentanil + Diphenoxylate-atropine Major
- Alvimopan + Diphenoxylate-atropine Major
- Amitriptyline + Diphenoxylate-atropine Major
Frequently asked questions
Can I take Benzhydrocodone / acetaminophen with Diphenoxylate-atropine?
MediHelp rates the interaction as major. Benzhydrocodone / acetaminophen and Diphenoxylate-atropine 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. Benzhydrocodone is an opioid prodrug of hydrocodone. Combining it with diphenoxylate, another opioid, increases risk of profound sedation and respiratory depression, and the atropine component may worsen constipation.
How serious is the interaction between Benzhydrocodone / acetaminophen and Diphenoxylate-atropine?
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 unnecessary co-prescription; if both are needed, use the lowest doses and shortest duration and monitor for sedation and respiratory depression.
What other medicines interact with Diphenoxylate-atropine?
MediHelp also lists interactions of Diphenoxylate-atropine with, for example, Isocarboxazid, Phenelzine, Tranylcypromine. The full list is on the Diphenoxylate-atropine page.
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