Benzodiazepine: Reactions with other drugs or substances

Last modified: Thursday, 25. December 2008 - 7:19 am

Benzodiazepines have an extremely low risk of acute toxicity when they are used alone. Unfortunately, these drugs are often used with other medications such as other CNS depressants, which can include commonly used antihistamines and alcohol, causing toxicity.

Drinking alcoholic beverages while taking any of the benzodiazepine medications will increase all the side effects of the benzodiazepine, especially the sedative effects and the tendency for slowed breathing. Concurrent use of alcohol and these drugs can also increase the memory lapses that occur with benzodiazepines. High doses of benzodiazepines and alcohol can impair an individual’s ability to breathe and dangerously lower blood pressures. This could result in coma and death. Alcohol and benzodiazepines should never be taken together.

Use of benzodiazepines with narcotics, such as meperidine (Demerol), oxycodone (Percodan), codeine, morphine, or pentazocine (Talwin), increase their sedative effects. Combining these agents can lead to serious reductions in breathing rate, and even death. These two types of drugs should never be taken together.

Benzodiazepines should not be used with other drugs that inhibit the CNS, including hypnotic agents, sedating antidepressants, neuroleptic agents, anticonvulsants, and even antihistamines. Combined use with the barbiturates and other sedatives, such as phenobarbitol (Luminal), pentobarbital (Nembutal), secobarbitol (Seconal), and amobarbital/secobarbital (Tuinal), can also increase sedation and depress breathing to dangerous levels.

Combined use of more than one benzodiazepine is unnecessary and unsafe, as is combined use of benzodiazepines and sleeping pills.

Certain drugs can reduce the ability of the liver to clear benzodiazepines from the body. These include ulcer drugs, such as cimetidine (Tagamet), birth control pills, propranolol (used to treat hypertension, heart disorders, and migraines), and disulfuram (Antabuse), which is used for the treatment of alcoholism.

Finally, benzodiazepines should not be used to treat anxiety that is associated with depression because sometimes these drugs can actually make the depression worse. Instead, the choice for treatment in such cases should be one of the antidepressant medications.

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