Drug interactions
Chlordiazepoxide-clidinium + Codeine
Severity: Major
Chlordiazepoxide-clidinium 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
Concomitant benzodiazepine and opioid use can cause profound sedation, respiratory depression, coma and death, a risk highlighted in regulatory boxed warnings.
What this interaction means in plain words
Chlordiazepoxide-clidinium 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-clidinium belongs to Gastrointestinal Tract; Codeine belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via GABA-A potentiation and opioid receptor agonism.
What to do
Reserve the combination for patients without alternatives, using the lowest doses and shortest duration, and monitor for respiratory depression and sedation. Counsel on avoiding alcohol.
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 Chlordiazepoxide-clidinium
- Alfentanil + Chlordiazepoxide-clidinium Major
- Alprazolam + Chlordiazepoxide-clidinium Major
- Amobarbital + Chlordiazepoxide-clidinium Major
- Belladonna and opium + Chlordiazepoxide-clidinium Major
- Benzhydrocodone / acetaminophen + Chlordiazepoxide-clidinium Major
- Brexanolone + Chlordiazepoxide-clidinium Major
Other interactions of Codeine
- Alvimopan + Codeine Contraindicated
- Codeine + Isocarboxazid Contraindicated
- Codeine + Olanzapine / samidorphan Contraindicated
- Codeine + Phenelzine Contraindicated
- Codeine + Tranylcypromine Contraindicated
- Alfentanil + Codeine Major
Frequently asked questions
Can I take Chlordiazepoxide-clidinium with Codeine?
MediHelp rates the interaction as major. Chlordiazepoxide-clidinium 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. Concomitant benzodiazepine and opioid use can cause profound sedation, respiratory depression, coma and death, a risk highlighted in regulatory boxed warnings.
How serious is the interaction between Chlordiazepoxide-clidinium 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: Reserve the combination for patients without alternatives, using the lowest doses and shortest duration, and monitor for respiratory depression and sedation. Counsel on avoiding alcohol.
What other medicines interact with Chlordiazepoxide-clidinium?
MediHelp also lists interactions of Chlordiazepoxide-clidinium with, for example, Alfentanil, Alprazolam, Amobarbital. The full list is on the Chlordiazepoxide-clidinium page.
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