STOP — Contraindicated
FDA Black Box Warning — this is one of the most commonly fatal prescription drug combinations in the US.
Evidence level: STRONG
Taking hydrocodone (found in Vicodin, Norco) with alprazolam (Xanax) can be fatal. Both suppress breathing, and the combination is one of the most common causes of prescription overdose deaths.
Combined CNS depression: opioid mu-receptor agonism plus GABA-A receptor potentiation. FDA Black Box Warning.
Never combine these without explicit doctor knowledge. If you have prescriptions from different doctors, make sure each knows about the other. Keep naloxone (Narcan) available if prescribed both.
Take Alprazolam only as prescribed — benzodiazepines carry dependence risk and should not be adjusted without medical guidance. Hydrocodone at a separate time. Benzodiazepines cause sedation — avoid combining with other sedating substances. Never increase dose without medical guidance.
Risk increases with higher doses of either substance, older age, liver or kidney impairment, and concurrent use of other serotonergic or CNS-depressant substances.
Extreme drowsiness, very slow or stopped breathing, limpness, bluish skin, inability to be woken up
Tell every doctor about all medications you take. Ask about naloxone (Narcan) for emergency use. Discuss alternative pain or anxiety treatments.
Opioid combinations carry serious risks including respiratory depression. Talk to your pain management specialist about non-opioid alternatives: physical therapy, NSAIDs (if appropriate), nerve blocks, or non-sedating supplements like PEA (palmitoylethanolamide) or curcumin for inflammation.
Taking hydrocodone (found in Vicodin, Norco) with alprazolam (Xanax) can be fatal. Both suppress breathing, and the combination is one of the most common causes of prescription overdose deaths.
Take Alprazolam only as prescribed — benzodiazepines carry dependence risk and should not be adjusted without medical guidance. Hydrocodone at a separate time. Benzodiazepines cause sedation — avoid combining with other sedating substances. Never increase dose without medical guidance.
Extreme drowsiness, very slow or stopped breathing, limpness, bluish skin, inability to be woken up
Opioid combinations carry serious risks including respiratory depression. Talk to your pain management specialist about non-opioid alternatives: physical therapy, NSAIDs (if appropriate), nerve blocks, or non-sedating supplements like PEA (palmitoylethanolamide) or curcumin for inflammation.
Tell every doctor about all medications you take. Ask about naloxone (Narcan) for emergency use. Discuss alternative pain or anxiety treatments.
Or browse the full interaction database (121,000+ pairs).