Drug interactions
Clorazepate + Hydromorphone
Severity: Major
Clorazepate and Hydromorphone: 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
Combining hydromorphone with the benzodiazepine clorazepate raises the risk of profound sedation, respiratory depression, coma and death. Clorazepate's long-acting active metabolite desmethyldiazepam prolongs the exposure.
What this interaction means in plain words
Clorazepate and Hydromorphone 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; Hydromorphone belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid and GABA-A receptor effects.
What to do
Avoid when possible; if both are required, limit doses and duration and monitor closely for sedation and respiratory depression. Consider naloxone availability.
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 Hydromorphone
- Alvimopan + Hydromorphone Contraindicated
- Bupropion-naltrexone + Hydromorphone Contraindicated
- Hydromorphone + Isocarboxazid Contraindicated
- Hydromorphone + Olanzapine / samidorphan Contraindicated
- Hydromorphone + Phenelzine Contraindicated
- Hydromorphone + Tranylcypromine Contraindicated
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 Hydromorphone?
MediHelp rates the interaction as major. Clorazepate and Hydromorphone 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. Combining hydromorphone with the benzodiazepine clorazepate raises the risk of profound sedation, respiratory depression, coma and death. Clorazepate's long-acting active metabolite desmethyldiazepam prolongs the exposure.
How serious is the interaction between Clorazepate and Hydromorphone?
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 when possible; if both are required, limit doses and duration and monitor closely for sedation and respiratory depression. Consider naloxone availability.
What other medicines interact with Hydromorphone?
MediHelp also lists interactions of Hydromorphone with, for example, Alvimopan, Bupropion-naltrexone, Isocarboxazid. The full list is on the Hydromorphone page.
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