mixing meds

	Asked by paradive (Male; 34; n/a; Relevant drugs:vicodin and ambien. ) on Thu 03, Dec 2009 11:24pm
	is it stupid to mix benzodiazepines with opiates? i've felt horrible ever since i was prescribed Vicodin and Ambien in tandem. i heard it can be lethal. is that true?
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	Answer by Dr. A. Srivastava (doctor) on Fri 04, Dec 2009 12:45am: Hello Sir, A very warm welcome to AMD forum. Vicodin contains acetaminophen and hydrocodone so it comes under narcotic (opiates) pain-killers. Ambien is Zolpidem tartrate which is indicated for treatment of insomnia. Ambien is a CNS depressant to induce sleep. It is known to cause around 609 drug interactions with various drugs therefore a careful evaluation of the candidature for the drug suitable with ambien is important and if there is any possible interaction then it is advisable to stop or reduce either of the drug depending on its importance for the patient’s health. Ambien do interact with Vicodin. Both the drugs are CNS depressants and may cause synergistic( additive) effect on brain. CNS depression can cause low BP, shallow breathing, fainting feeling, euphoria, lack of mental alertness( may lead to confusion) and decreased motor abilities of the person. Prolonged CNS depression can lead to respiratory depression which can be life- threatening in severe cases. As you are having both the drugs concomitantly then your symptoms may become accentuated due to this additive effect. Please notify your physician about any prolonged CNS effect and until any action taken by your doctor, you should avoid activities requiring mental alertness (jobs in factories or similar occupations) in potentially hazardous areas. Avoid any alcohol as it may aggravate your problem (alcohol is also CNS depressant and liver toxic). Be careful to avoid driving until your CNS effects persist. Therefore a prompt evaluation by your treating doctor to adjust both or stop any of the two drugs (do not stop abruptly by yourself, they need to be “Tapered down” to avoid withdrawal effects) in favor of your wellbeing is advisable. Here is a link, incase you want to know more on Ambien's interactions. http://www.drugs.com/drug-interactions/ambien-with-vicodin-71-747-2333-1544.html Hope this information helps. In case of any further queries and clarification, do keep us posted. Take care and Regards AMD.
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	Comments: Response by Dr Bhupinder K, MD on Fri 04, Dec 2009 05:49am: Hello, Dr Anurag has explained the possible interaction between Vicodin and Ambien very well and he is right in stating the precautions that are to be taken if you are taking them together. Ambien is a non benzodiazepine hypnotic and it is a CNS depressant drug which can cause impairment in concentration and sleepiness. On the other hand Vicodin contains Acetaminophen and Opioids which can cause moderate interactions when taken with Ambien. Along with the measures that Dr Anurag has stated, you can take Ambien at bedtime and Vicodin during the day or get dose of Ambien reduced after consulting your doctor. Hope it helps. Take care and please do keep me posted if you have any additional queries. Warm regards.
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