Drug interactions
Codeine + Diazepam intranasal
Severity: Major
Codeine and Diazepam intranasal: 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 such as diazepam can cause profound sedation, respiratory depression, coma and death. This is a boxed-warning interaction for the class.
What this interaction means in plain words
Codeine and Diazepam intranasal 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.
Why it happens
Additive CNS and respiratory depression via opioid receptor agonism and GABA-A potentiation.
What to do
Reserve combined use for patients without adequate alternatives, with the lowest doses and shortest duration. Monitor for sedation and respiratory depression, and counsel patients and carers.
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 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 Codeine with Diazepam intranasal?
MediHelp rates the interaction as major. Codeine and Diazepam intranasal 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 such as diazepam can cause profound sedation, respiratory depression, coma and death. This is a boxed-warning interaction for the class.
How serious is the interaction between Codeine and Diazepam intranasal?
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 combined use for patients without adequate alternatives, with the lowest doses and shortest duration. Monitor for sedation and respiratory depression, and counsel patients and carers.
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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