Drug interactions
Diazepam intranasal + Meperidine
Severity: Major
Diazepam intranasal and Meperidine: 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 given with benzodiazepines such as intranasal diazepam can cause profound sedation, respiratory depression, coma and death. Risk is greatest at higher doses and in patients with compromised breathing.
What this interaction means in plain words
Diazepam intranasal and Meperidine 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 opioid receptor activity and GABA-A potentiation.
What to do
Reserve concurrent use for patients without adequate alternatives, limit doses and duration, and monitor respiratory rate and level of sedation.
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 Meperidine
- Alvimopan + Meperidine Contraindicated
- Isocarboxazid + Meperidine Contraindicated
- Meperidine + Methylene blue Contraindicated
- Meperidine + Olanzapine / samidorphan Contraindicated
- Meperidine + Phenelzine Contraindicated
- Meperidine + Procarbazine Contraindicated
Frequently asked questions
Can I take Diazepam intranasal with Meperidine?
MediHelp rates the interaction as major. Diazepam intranasal and Meperidine 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 given with benzodiazepines such as intranasal diazepam can cause profound sedation, respiratory depression, coma and death. Risk is greatest at higher doses and in patients with compromised breathing.
How serious is the interaction between Diazepam intranasal and Meperidine?
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 concurrent use for patients without adequate alternatives, limit doses and duration, and monitor respiratory rate and level of sedation.
What other medicines interact with Meperidine?
MediHelp also lists interactions of Meperidine with, for example, Alvimopan, Isocarboxazid, Methylene blue. The full list is on the Meperidine page.
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