Drug interactions
Diazepam intranasal + Hydrocodone
Severity: Major
Diazepam intranasal 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
Opioids combined with benzodiazepines carry a boxed warning for profound sedation, respiratory depression, coma and death. Intranasal diazepam is rapidly absorbed, so the combined effect may appear quickly.
What this interaction means in plain words
Diazepam intranasal 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.
Why it happens
Additive CNS and respiratory depression from GABA-A potentiation and mu-opioid agonism.
What to do
Reserve combined use for patients with no alternatives, using the lowest doses for the shortest time. Monitor respiratory rate and sedation and 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 Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Frequently asked questions
Can I take Diazepam intranasal with Hydrocodone?
MediHelp rates the interaction as major. Diazepam intranasal 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. Opioids combined with benzodiazepines carry a boxed warning for profound sedation, respiratory depression, coma and death. Intranasal diazepam is rapidly absorbed, so the combined effect may appear quickly.
How serious is the interaction between Diazepam intranasal 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: Reserve combined use for patients with no alternatives, using the lowest doses for the shortest time. Monitor respiratory rate and sedation and consider naloxone availability.
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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