STOP — Contraindicated
FDA Black Box Warning — avoid concurrent use. Deaths have occurred. If co-prescribing is unavoidable, use lowest doses and shortest duration.
Evidence level: STRONG
Taking an opioid painkiller with a benzodiazepine sedative is extremely dangerous. Both drugs slow your breathing, and together they can slow it to a life-threatening level. The FDA has placed its strongest warning (Black Box) on this combination.
Combined CNS depression: opioid mu-receptor agonism plus GABA-A receptor potentiation causes additive respiratory depression. FDA Black Box Warning on all opioid and benzodiazepine labels.
Do not take these together unless specifically directed by your doctor who has weighed the risks. Never combine leftover opioids with anxiety medications. If prescribed both, your doctor should start at the lowest possible doses.
Take Alprazolam only as prescribed — benzodiazepines carry dependence risk and should not be adjusted without medical guidance. Oxycodone 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, slowed or shallow breathing, unresponsiveness, bluish lips or fingertips, loss of consciousness
Ask your doctor: Why do I need both medications? Can we use a non-opioid pain option or a non-benzodiazepine for anxiety? What is the plan to taper off one of these?
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 an opioid painkiller with a benzodiazepine sedative is extremely dangerous. Both drugs slow your breathing, and together they can slow it to a life-threatening level. The FDA has placed its strongest warning (Black Box) on this combination.
Take Alprazolam only as prescribed — benzodiazepines carry dependence risk and should not be adjusted without medical guidance. Oxycodone at a separate time. Benzodiazepines cause sedation — avoid combining with other sedating substances. Never increase dose without medical guidance.
Extreme drowsiness, slowed or shallow breathing, unresponsiveness, bluish lips or fingertips, loss of consciousness
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.
Ask your doctor: Why do I need both medications? Can we use a non-opioid pain option or a non-benzodiazepine for anxiety? What is the plan to taper off one of these?
Or browse the full interaction database (121,000+ pairs).