Drug interactions
Diazepam intranasal + Hydromorphone
Severity: Major
Diazepam intranasal 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
Benzodiazepines combined with opioids can cause profound sedation, respiratory depression, coma and death. Intranasal diazepam is absorbed quickly, so effects can appear rapidly.
What this interaction means in plain words
Diazepam intranasal 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.
Why it happens
Additive CNS and respiratory depression through GABA-A potentiation and mu-opioid agonism.
What to do
Reserve the combination for patients without alternatives, using the lowest doses and shortest duration, and monitor respiratory rate and level of consciousness. Ensure naloxone is accessible and counsel caregivers.
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
Frequently asked questions
Can I take Diazepam intranasal with Hydromorphone?
MediHelp rates the interaction as major. Diazepam intranasal 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. Benzodiazepines combined with opioids can cause profound sedation, respiratory depression, coma and death. Intranasal diazepam is absorbed quickly, so effects can appear rapidly.
How serious is the interaction between Diazepam intranasal 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: Reserve the combination for patients without alternatives, using the lowest doses and shortest duration, and monitor respiratory rate and level of consciousness. Ensure naloxone is accessible and counsel caregivers.
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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