Drug interactions
Chlordiazepoxide + Diphenoxylate-atropine
Severity: Major
Chlordiazepoxide and Diphenoxylate-atropine: 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 combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death. Diphenoxylate is a weak oral opioid at usual doses, but overdose or high-dose use increases this risk.
What this interaction means in plain words
Chlordiazepoxide 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.
Chlordiazepoxide belongs to Central Nervous System; Diphenoxylate-atropine belongs to Gastrointestinal Tract.
Why it happens
Additive CNS and respiratory depression via opioid and GABA-A receptor effects.
What to do
Avoid combination where possible; if needed, use the lowest doses for the shortest duration and monitor for sedation and slowed breathing.
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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References
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
Other interactions of Chlordiazepoxide
Frequently asked questions
Can I take Chlordiazepoxide with Diphenoxylate-atropine?
MediHelp rates the interaction as major. Chlordiazepoxide 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. Opioids combined with benzodiazepines can cause profound sedation, respiratory depression, coma and death. Diphenoxylate is a weak oral opioid at usual doses, but overdose or high-dose use increases this risk.
How serious is the interaction between Chlordiazepoxide 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 combination where possible; if needed, use the lowest doses for the shortest duration and monitor for sedation and slowed breathing.
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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