Drug interactions
Diazepam + Hydromorphone
Severity: Major
Diazepam 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
Diazepam combined with hydromorphone can cause profound sedation, respiratory depression, coma and death, as described in regulatory boxed warnings for opioid and benzodiazepine co-use. Diazepam's long-acting metabolites prolong the risk.
What this interaction means in plain words
Diazepam 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.
Diazepam belongs to Musculoskeletal; Hydromorphone belongs to Musculoskeletal.
Why it happens
Additive CNS and respiratory depression via opioid and GABA-A receptor effects.
What to do
Avoid unless no alternatives exist; use the lowest doses and shortest duration with close monitoring of sedation and breathing. Consider naloxone co-prescription.
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 Diazepam
Frequently asked questions
Can I take Diazepam with Hydromorphone?
MediHelp rates the interaction as major. Diazepam 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. Diazepam combined with hydromorphone can cause profound sedation, respiratory depression, coma and death, as described in regulatory boxed warnings for opioid and benzodiazepine co-use. Diazepam's long-acting metabolites prolong the risk.
How serious is the interaction between Diazepam 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 unless no alternatives exist; use the lowest doses and shortest duration with close monitoring of sedation and breathing. Consider naloxone co-prescription.
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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