Can You Take Codeine with Diazepam?
Last reviewed: · Source: US FDA drug label database
Avoid — codeine and diazepam together can cause dangerous respiratory depression, particularly in the elderly and those with lung conditions.
Is it safe to take Codeine with Diazepam?
Codeine (an opioid) and diazepam (a benzodiazepine) are both central nervous system depressants. When combined, their sedative effects add together (and can multiply), increasing the risk of severe drowsiness, slowed or stopped breathing, low blood pressure, coma, and death. The FDA issued a black box warning for this opioid-benzodiazepine combination. This combination should only ever be used under close medical supervision when both drugs are specifically prescribed together.
How do Codeine and Diazepam interact?
Codeine activates mu-opioid receptors, reducing respiratory drive and CNS activity. Diazepam enhances GABA-A receptor activity, also reducing CNS activity and respiratory function. These two different mechanisms of CNS/respiratory depression are additive or synergistic. Together they can suppress breathing to the point where it stops. This is the mechanism behind many accidental overdose deaths.
Data sourced from the US Food and Drug Administration (FDA) drug label database: FDA Black Box Warning — concomitant use of opioids and benzodiazepines; OpenFDA drug label data.
Who should be careful?
Everyone, but especially: elderly patients, those with COPD, sleep apnoea, or asthma, people who use alcohol, and those taking any other sedating medication. People with lower body weight or poor general health are also at higher risk.
What if I've already taken Codeine and Diazepam?
If you feel very drowsy, confused, have slow/shallow breathing, blue lips, or cannot be woken, call 999 immediately. This is a medical emergency. If the person is unresponsive, put them in the recovery position while waiting for help.
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Frequently Asked Questions
Can you take codeine and diazepam together?
Generally no — this is a dangerous combination that can cause respiratory depression. It should only ever be used if both are specifically prescribed by a doctor who is aware you are taking both.
Why is mixing opioids and benzodiazepines dangerous?
Both suppress breathing and the central nervous system, and together their effects multiply. This can cause breathing to slow or stop entirely. It is a common factor in accidental overdose deaths.
Can I take diazepam for anxiety while on codeine?
You must tell your doctor about the codeine before any diazepam is prescribed. A safer alternative for anxiety may be recommended. Never self-medicate with diazepam if you are already taking an opioid.
What are the signs of respiratory depression from codeine and diazepam?
Warning signs include very slow or shallow breathing, extreme drowsiness or inability to wake, blue or grey lips or fingertips, and unresponsiveness. Call 999 immediately if you see these signs.