Drug interactions
Clorazepate + Hydrocodone
Severity: Major
Clorazepate and Hydrocodone: 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
Taking hydrocodone with clorazepate can cause profound sedation, respiratory depression, coma and death. This is a recognised opioid-benzodiazepine boxed-warning interaction.
What this interaction means in plain words
Clorazepate and Hydrocodone 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.
Clorazepate belongs to Central Nervous System; Hydrocodone belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid receptors and GABA-A potentiation.
What to do
Avoid unless no alternatives exist; if used together, give the lowest doses for the shortest time and monitor respiratory status and sedation. Consider co-prescribing 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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References
Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Other interactions of Clorazepate
- Calcium / magnesium / potassium / sodium oxybates + Clorazepate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
- Alfentanil + Clorazepate Major
- Alprazolam + Clorazepate Major
- Amobarbital + Clorazepate Major
- Belladonna and opium + Clorazepate Major
Frequently asked questions
Can I take Clorazepate with Hydrocodone?
MediHelp rates the interaction as major. Clorazepate and Hydrocodone 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. Taking hydrocodone with clorazepate can cause profound sedation, respiratory depression, coma and death. This is a recognised opioid-benzodiazepine boxed-warning interaction.
How serious is the interaction between Clorazepate and Hydrocodone?
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 unless no alternatives exist; if used together, give the lowest doses for the shortest time and monitor respiratory status and sedation. Consider co-prescribing naloxone.
What other medicines interact with Hydrocodone?
MediHelp also lists interactions of Hydrocodone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydrocodone page.
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