Can You Take Zopiclone with Codeine?
Last reviewed: · Source: US FDA drug label database
Zopiclone plus codeine combines two central nervous system depressants — the pairing risks dangerously suppressed breathing during sleep and should be avoided.
Is it safe to take Zopiclone with Codeine?
Zopiclone is a sleeping tablet that depresses the central nervous system; codeine is an opioid that does the same and specifically suppresses the breathing centre. Taken together — especially at night, which is exactly when both are typically taken — they can slow breathing to dangerous levels. Deaths involving Z-drugs almost always involve another depressant such as an opioid or alcohol. Do not add over-the-counter co-codamol to prescribed zopiclone without medical advice.
How do Zopiclone and Codeine interact?
Zopiclone potentiates GABA-A receptor inhibition; codeine's metabolite morphine agonises mu-opioid receptors in the medullary respiratory centres. Combined GABAergic and opioid respiratory depression is synergistic and most dangerous during sleep, when arousal responses to hypoxia and hypercapnia are already blunted.
Data sourced from the US Food and Drug Administration (FDA) drug label database: OpenFDA zopiclone/eszopiclone class labelling — CNS depressant co-administration warnings.
Who should be careful?
Everyone — particularly people with sleep apnoea or snoring, COPD or asthma, the elderly, ultra-rapid codeine metabolisers, and anyone who has consumed alcohol the same evening.
What if I've already taken Zopiclone and Codeine?
If you've taken both tonight, do not take any more of either, avoid alcohol completely, and ideally have someone aware who can check on you. Seek emergency help for very slow breathing, unrousable sleepiness, or blue lips. Longer term, ask your GP to review — pain and insomnia can usually be managed with a safer plan.
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Frequently Asked Questions
Can I take zopiclone with co-codamol?
This should be avoided unless a prescriber has explicitly planned it. Both depress breathing and the risk is highest overnight.
I take codeine for chronic pain — can I have a sleeping tablet?
Discuss with your GP. If a hypnotic is essential, the lowest dose for the shortest time with review is the rule — and the opioid dose matters.
What sleep aids are safer with codeine?
Sleep hygiene measures and CBT-i are first line. Ask a pharmacist before using even OTC sedating antihistamines, which also add drowsiness.
What are the danger signs overnight?
Very slow, shallow or irregular breathing, deep snoring or gurgling with difficulty rousing, blue lips or fingertips. Call 999.