When To Take Hydrocodone After Valium

In our latest question and answer, the pharmacist discusses when it would be considered safe to take hydrocodone after Valium (diazepam).

Question

If I take a diazapm at 10pm, can I take a hydrocodone at 8 am along with a methacarbomal?

Asked by RocTay On May 01, 2018

Answered by
Medical Content Reviewed By PharmacistAnswers Staff

On May 07, 2018

Taking Valium (diazepam) and hydrocodone generally isn't recommended due to the risk of serious side effects such as excess sedation and respiratory depression. In fact, the FDA in August 2016 released a safety communication warning of the dangers when combining opioids, like hydrocodone and benzodiazpines, like Valium.


Per The FDA:

"A U.S. Food and Drug Administration (FDA) review has found that the growing combined use of opioid medicines with benzodiazepines or other drugs that depress the central nervous system (CNS) has resulted in serious side effects, including slowed or difficult breathing and deaths"

While sometimes the combination may be necessary for a patient, doses of Valium and hydrocodone should be initiated at the lowest effective doses and minimum treatment duration needed. In addition, patients should be aware of symptoms of side effects such as:

  • Hypotension
  • Profound sedation
  • Dizziness
  • Shallow breathing


How Long To Separate Valium And Hydrocodone

If you have been prescribed both hydrocodone and Valium, it may be prudent to separate doses by as long as possible to avoid the additive side effects of each. Each dose of Valium lasts around 4 to 12 hours depending on the individual. Ideally, you should wait at least 4 to 12 hours after taking Valium to take hydrocodone to lessen additive sedation, but this will not completely avoid the interaction.


Valium has an extremely long half life, around 30 to 60 hours. Active metabolites of Valium have an even longer half-life, closer to 100 hours. The half-life of a drug is how long it takes for 50% of a drug to be metabolized in the body. It generally takes around 5 to 6 half-lives for a drug to be completely eliminated in the body. Therefore, Valium can be detected in the body in most individuals for nearly a week, if not longer!


The general recommendation for combined use of benzodiazepines and opioids to initiate the dose of the additive agent at the lowest possible dose and titrate (i.e. increase) to clinical effect. In addition, it is important to be educated about the risks and symptoms of respiratory depression and sedation.


Additional Information

Adding on additional CNS depressant medications, such as muscle relaxants, is generally not recommended. Benzodiazepines often have muscle relaxants effects and can sometimes be used solely for that. Muscle relaxants will just enhance the sedative and potential respiratory effects. Although the use of an opioid, benzodiazepine and muscle relaxant wouldn't be unheard of, you need to be aware of the risks and speak with your doctor about optimal drug therapy for your situation.


Summary

  • Hydrocodone should be given at least 6 to 12 hours after Valium if possible, but this will not completely avoid the interaction.
  • Valium has an extremely long half-life and is detectable in the body for 5 to 10 days for most individuals.
  • If taking hydrocodone and Valium together, use the lowest possible doses for the shortest amount of time, and be aware of the symptoms of excessive sedation and respiratory depression.

About the Pharmacist

Dr. Brian Staiger Pharm.D

Dr. Brian Staiger is a licensed pharmacist in New York State and the founder of PharmacistAnswers.com. He graduated from the University At Buffalo with a Doctor of Pharmacy degree in 2010. He has been featured in numerous publications including the Huffington Post as well as a variety of health and pharmacy-related blogs. Please feel free to reach out to him directly if you have any inquiries or want to connect! He's answered thousands of medication and pharmacy-related questions and he's ready to answer yours! Brian.Staiger@PharmacistAnswers.com Office: 716-389-3076

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