Drug reference directory
Drug reference

opioids

Drug monograph

CDSCO approved
EXCRETION
—
not curated
INTERACTIONS
11 major
incl. contraindicated
PREGNANCY
—
not curated
Top interactionssee all 11 →
  • AlprazolamContraindicatedDatabaseKimi deep-research + Cla
  • ClonazepamContraindicatedDatabaseKimi deep-research + Cla
  • ChlordiazepoxideSevereDatabaseKimi deep-research + Cla
  • DiazepamSevereDatabaseKimi deep-research + Cla

Mechanism

Not yet extracted

Side effects

Common
psychological dependencephysical dependencestrong reinforcement leading to drug-seeking behaviour

Drug interactions

Alprazolam
Contraindicated
Database

FDA black box warning: combined CNS depression at GABA-A and mu-opioid receptors causes profound respiratory depression, coma, and death.

Avoid concurrent use. If absolutely necessary in supervised settings, lowest doses, shortest duration, monitor respiratory rate and oxygen saturation. Naloxone availability.

Source: Kimi deep-research + Cla

Clonazepam
Contraindicated
Database

FDA black box warning: combined use of benzodiazepines and opioids causes profound respiratory depression, coma, and death via synergistic CNS depression at different receptor sites (GABA-A and mu-opioid).

Avoid concurrent use. If absolutely necessary in supervised settings, limit to lowest doses, shortest duration, monitor respiratory rate and oxygen saturation, and ensure naloxone availability.

Source: Kimi deep-research + Cla

Chlordiazepoxide
Severe
Database

Additive CNS/respiratory depression

Avoid (boxed warning class)

Source: Kimi deep-research + Cla

Diazepam
Severe
Database

Additive respiratory depression, sedation, coma, death; FDA black box warning

Avoid concurrent use if possible; if unavoidable, monitor respiratory rate closely and have naloxone available

Source: Kimi deep-research + Cla

Flurazepam
Severe
Database

Additive CNS/respiratory depression

Avoid combination; boxed warning class

Source: Kimi deep-research + Cla

Gabapentin
Severe
Database

Pharmacodynamic synergy causing respiratory depression. Gabapentin + opioids significantly increase risk of opioid-induced respiratory depression, sedation, and death. FDA issued warning December 2019.

Avoid concurrent use if possible. If necessary, use lowest effective doses of both, limit duration, and monitor closely for sedation and respiratory depression. Consider naloxone availability.

Source: Kimi deep-research + Cla

Lorazepam
Severe
Database

Additive respiratory depression, sedation, coma, death; FDA black box warning

Avoid concurrent use if possible; if unavoidable, monitor respiratory rate closely and have naloxone available

Source: Kimi deep-research + Cla

Midazolam
Severe
Database

Profound additive respiratory depression/sedation (boxed)

Avoid combination; if essential lowest doses, monitored setting, naloxone/flumazenil ready

Source: Kimi deep-research + Cla

Oxazepam
Severe
Database

Additive CNS/respiratory depression

Avoid combination (boxed warning class)

Source: Kimi deep-research + Cla

Pregabalin
Severe
Database

Additive CNS and respiratory depression. Pregabalin and opioids both depress central respiratory drive. Concurrent use significantly increases risk of profound sedation, respiratory depression, coma, and death, particularly in elderly or opioid-naive patients.

Avoid concurrent use if possible. If combination is necessary, use lowest effective doses of both agents, monitor respiratory rate closely (target ≥10 breaths/min), and consider naloxone availability. Start with reduced opioid dose (25-50% less) and titrate cautiously.

Source: Kimi deep-research + Cla

Propofol
Severe
Database

Additive hypnosis, hypotension and respiratory depression

Reduce propofol dose; titrate; full monitoring/airway

Source: Kimi deep-research + Cla

1 additional unreviewed or low-confidence interaction hidden because their provenance or source detail is insufficient.

Other Unclassified drugs

Ask House about opioids

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Textbook-sourced·Sources: KD Tripathi 7e·Updated: 2026-05-10