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Drug interactions

Chlordiazepoxide + Codeine

Severity: Major

Chlordiazepoxide and Codeine: major interaction.

Last updated Sources: US FDA label

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 with benzodiazepines can cause profound sedation, respiratory depression, coma and death, and regulators carry a boxed warning for this pairing.

What this interaction means in plain words

Chlordiazepoxide and Codeine 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.

Chlordiazepoxide belongs to Central Nervous System; Codeine belongs to Musculoskeletal.

Evidence level: High

Why it happens

Additive CNS and respiratory depression via opioid and GABA-A receptor effects.

What to do

Avoid concurrent use if possible; if required, limit doses and 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?

Bring a full list of your medicines, including over-the-counter products, supplements and herbal remedies, to every pharmacy visit.

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References

Frequently asked questions

Can I take Chlordiazepoxide with Codeine?

MediHelp rates the interaction as major. Chlordiazepoxide and Codeine 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 with benzodiazepines can cause profound sedation, respiratory depression, coma and death, and regulators carry a boxed warning for this pairing.

How serious is the interaction between Chlordiazepoxide and Codeine?

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 if possible; if required, limit doses and duration and monitor for sedation and respiratory depression.

What other medicines interact with Codeine?

MediHelp also lists interactions of Codeine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Codeine page.

Full monographs, dosing and an interaction checker in the MediHelp app

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