Drug interactions
Clobazam + Codeine
Severity: Major
Clobazam and Codeine: 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
Benzodiazepines combined with opioids carry a boxed warning for profound sedation, respiratory depression, coma and death. Clobazam may also weakly inhibit CYP2D6, which could reduce activation of codeine to morphine.
What this interaction means in plain words
Clobazam 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.
Clobazam belongs to Central Nervous System; Codeine belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression, plus possible CYP2D6 inhibition by clobazam.
What to do
Avoid or limit to patients with no alternative, using the lowest doses and shortest duration. Monitor for sedation and respiratory depression, and consider naloxone.
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 Codeine
- Alvimopan + Codeine Contraindicated
- Codeine + Isocarboxazid Contraindicated
- Codeine + Olanzapine / samidorphan Contraindicated
- Codeine + Phenelzine Contraindicated
- Codeine + Tranylcypromine Contraindicated
- Alfentanil + Codeine Major
Other interactions of Clobazam
- Amobarbital + Clobazam Major
- Buprenorphine + Clobazam Major
- Butorphanol + Clobazam Major
- Carisoprodol + Clobazam Major
- Chloral hydrate + Clobazam Major
- Clobazam + Clozapine Major
Frequently asked questions
Can I take Clobazam with Codeine?
MediHelp rates the interaction as major. Clobazam 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. Benzodiazepines combined with opioids carry a boxed warning for profound sedation, respiratory depression, coma and death. Clobazam may also weakly inhibit CYP2D6, which could reduce activation of codeine to morphine.
How serious is the interaction between Clobazam 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 or limit to patients with no alternative, using the lowest doses and shortest duration. Monitor for sedation and respiratory depression, and consider naloxone.
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.
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