Drug interactions
Hydrocodone + Remimazolam
Severity: Major
Hydrocodone and Remimazolam: major interaction.
Last updated
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
Remimazolam is a benzodiazepine and combined with an opioid it increases the risk of deep sedation and respiratory depression. Severe cases may progress to hypoxia, coma or death.
What this interaction means in plain words
Hydrocodone and Remimazolam 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.
Hydrocodone belongs to Musculoskeletal; Remimazolam belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression through GABA-A potentiation plus opioid receptor agonism.
What to do
Titrate remimazolam carefully and use reduced doses in patients on opioids. Monitor vital signs and oxygen saturation continuously during the procedure and recovery.
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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Other interactions of Hydrocodone
- Alvimopan + Hydrocodone Contraindicated
- Bupropion-naltrexone + Hydrocodone Contraindicated
- Hydrocodone + Isocarboxazid Contraindicated
- Hydrocodone + Olanzapine / samidorphan Contraindicated
- Hydrocodone + Phenelzine Contraindicated
- Alfentanil + Hydrocodone Major
Other interactions of Remimazolam
Frequently asked questions
Can I take Hydrocodone with Remimazolam?
MediHelp rates the interaction as major. Hydrocodone and Remimazolam 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. Remimazolam is a benzodiazepine and combined with an opioid it increases the risk of deep sedation and respiratory depression. Severe cases may progress to hypoxia, coma or death.
How serious is the interaction between Hydrocodone and Remimazolam?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Titrate remimazolam carefully and use reduced doses in patients on opioids. Monitor vital signs and oxygen saturation continuously during the procedure and recovery.
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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