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drug interaction(s) of benzodiazepine with opiates
Epidemiology:
- concurrent use of benzodiazepines with opiates is on the rise [4]
Drug interactions:
- concurrent benzodiazepine & opiate is associated with excess risk for overdose-related emergency room visits, hospital admissions, & death [1,4]
- benzodiazepines & opiates should not be used in combination [3]
- risk of overdose is increased with multiple prescribers [5]
Notes:
- new concurrent prescriptions of opiates & benzodiazepines decreased by ~57% from 2016 to 2019.
Properties
DRUGS: benzodiazepine
opioid agonist
References
- Park TW et al.
Benzodiazepine prescribing patterns and deaths from drug
overdose among US veterans receiving opioid analgesics:
Case-cohort study.
BMJ 2015; 350:h2698
PMID: 26063215
http://www.bmj.com/content/350/bmj.h2698
- FDA Safety Alert. Aug 31, 2016
Opioid Pain or Cough Medicines Combined With Benzodiazepines:
Drug Safety Communication - FDA Requiring Boxed Warning About
Serious Risks and Death.
http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm518710.htm
- FDA drug safety communication: Aug 31, 2016.
FDA warns about serious risks and death when combining opioid pain
or cough medicines with benzodiazepines; requires its strongest warning.
https://www.fda.gov/Drugs/DrugSafety/ucm518473.htm
- Anello J, Feinberg B, Heinegg J et al
New Guidelines and Recommendations
Guideline on oioid administration by Veterans Affaris and
U.S. Department of Defense
http://reference.medscape.com/features/slideshow/guidelines/2017/april
- Sun EC, Dixit A, Humphreys K et al
Association between concurrent use of prescription opioids
and benzodiazepines and overdose: retrospective analysis.
BMJ 2017;356:j760
PMID: 28292769 Free full text
http://www.bmj.com/content/356/bmj.j760
- Karaca-Mandic P, Meara E, Morden NE.
The growing problem of co-treatment with opioids and
benzodiazepines.
BMJ 2017;356:j1224
PMID: 28292825 Free full text
http://www.bmj.com/content/356/bmj.j1224
- Chua KP, Brummett CM, Ng S et al
Association Between Receipt of Overlapping Opioid and Benzodiazepine
Prescriptions From Multiple Prescribers and Overdose Risk.
JAMA Netw Open. 2021;4(8):e2120353
PMID: 34374769 Free article
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2782842
- Zhang K et al.
Trends in concurrent opioid and benzodiazepine prescriptions in the
United States, 2016 to 2019.
Ann Intern Med 2022 Jun 7; [e-pub].
PMID: 35667064
https://www.acpjournals.org/doi/10.7326/M21-4656