Zolpidem with Pentazocine Interaction Details
Brand Names Associated with Zolpidem
- Ambien®
- Ambien® CR
- Edluar®
- Intermezzo®
- Zolpidem
- Zolpimist®
Brand Names Associated with Pentazocine
- Pentazocine
- Talacen® (as a combination product containing Acetaminophen, Pentazocine)
- Talwin® NX
Medical Content Editor Dr. Brian Staiger, PharmD
Last updated
Nov 12, 2023
Interaction Effect
Increased risk of respiratory and CNS depression
Interaction Summary
The rate of emergency department visits involving non-medical use of concomitant benzodiazepines and opioid analgesics increased significantly over the period from 2004 to 2011 and deaths from drug overdose involving concomitant benzodiazepines and opioid analgesics also increased. The proportion of opioid overdose deaths for which benzodiazepines were also implicated increased over the same time period. In a study, overdose deaths in patients who were dispensed both opioids and benzodiazepines were 10-fold greater than those dispensed opioids alone. Another study in the Veterans Health Administration demonstrated that patients taking opioids with a benzodiazepine prescription history or current benzodiazepine prescriptions had an increased risk of death due to overdose compared with patients taking opioids without a history of benzodiazepine prescription; as daily benzodiazepine doses increased, risk of death due to drug overdose increased as well. Reserve the concomitant use of pentazocine and CNS depressants to patients for whom alternatives are inadequate. If concomitant use is necessary, use the lowest dose and shortest duration necessary to achieve treatment goals. Consider using a lower dose of pentazocine or the CNS depressant and closely monitor for sedation and respiratory depression .
Severity
Major
Onset
Unspecified
Evidence
Theoretical
How To Manage Interaction
Reserve the concomitant use of pentazocine and CNS depressants to patients for whom alternatives are inadequate. If concomitant use is necessary, use the lowest dose and shortest duration necessary to achieve treatment goals. Consider using a lower dose of pentazocine or the CNS depressant and closely monitor for sedation and respiratory depression.
Mechanism Of Interaction
Additive CNS depression
Literature Reports
A) The rate of emergency department visits involving non-medical use of concomitant benzodiazepines and opioid analgesics increased significantly over the period from 2004 to 2011, from 11 visits per 100,000 population to 34.2 visits per 100,000 population. Also, deaths from drug overdose involving concomitant benzodiazepines and opioid analgesics (including both prescribed doses and doses greater than prescribed) increased from 0.6 per 100,000 population to 1.7 per 100,000 population. The proportion of opioid overdose deaths for which benzodiazepines were also implicated increased from 18% to 31%
B) In a prospective cohort study performed in North Carolina, overdose deaths in patients who were dispensed both opioids and benzodiazepines were 10-fold greater than those dispensed opioids alone (7 per 10,000 person-years vs 0.7 per 10,000 person-years). A case-cohort study in the Veterans Health Administration demonstrated that patients taking opioids with a benzodiazepine prescription history or current benzodiazepine prescriptions had an increased risk of death due to overdose compared with patients taking opioids without a history of benzodiazepine prescription, risk increased 2.33- to 3.86-fold in patient with current or historical prescriptions for benzodiazepines. As daily benzodiazepine doses increased, risk of death due to drug overdose increased as well
Zolpidem Overview
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Zolpidem is used to treat insomnia (difficulty falling asleep or staying asleep). Zolpidem belongs to a class of medications called sedative-hypnotics. It works by slowing activity in the brain to allow sleep.
Pentazocine Overview
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Pentazocine is used to relieve moderate to severe pain. Pentazocine is in a class of medications called opiate (narcotic) analgesics. It works by changing the way the brain and nervous system respond to pain.
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Definitions
Severity Categories
Contraindicated
These drugs, generally, should not be used together simultaneously due to the high risk of severe adverse effects. Combining these medications can lead to dangerous health outcomes and should be strictly avoided unless otherwise instructed by your provider.
Major
This interaction could result in very serious and potentially life-threatening consequences. If you are taking this drug combination, it is very important to be under close medical supervision to minimize severe side effects and ensure your safety. It may be necessary to change a medication or dosage to prevent harm.
Moderate
This interaction has the potential to worsen your medical condition or alter the effectiveness of your treatment. It's important that you are monitored closely and you potentially may need to make adjustments in your treatment plan or drug dosage to maintain optimal health.
Minor
While this interaction is unlikely to cause significant problems, it could intensify side effects or reduce the effectiveness of one or both medications. Monitoring for changes in symptoms and your condition is recommended, and adjustments may be made if needed to manage any increased or more pronounced side effects.
Onset
Rapid: Onset of drug interaction typically occurs within 24 hours of co-administration.
Delayed: Onset of drug interaction typically occurs more than 24 hours after co-administration.
Evidence
Level of documentation of the interaction.
Established: The interaction is documented and substantiated in peer-reviewed medical literature.
Theoretical: This interaction is not fully supported by current medical evidence or well-documented sources, but it is based on known drug mechanisms, drug effects, and other relevant information.
How To Manage The Interaction
Provides a detailed discussion on how patients and clinicians can approach the identified drug interaction as well as offers guidance on what to expect and strategies to potentially mitigate the effects of the interaction. This may include recommendations on adjusting medication dosages, altering the timing of drug administration, or closely monitoring for specific symptoms.
It's important to note that all medical situations are unique, and management approaches should be tailored to individual circumstances. Patients should always consult their healthcare provider for personalized advice and guidance on managing drug interactions effectively.
Mechanism Of Interaction
The theorized or clinically determined reason (i.e., mechanism) why the drug-drug interaction occurs.
Disclaimer: The information provided on this page is for informational purposes only and should not be considered medical advice. Always consult with a qualified healthcare professional regarding your specific circumstances and medical conditions.
Where Does Our Information Come From?
Information for our drug interactions is compiled from several drug compendia, including:
The prescribing information for each drug, as published on DailyMED, is also used.
Individual drug-drug interaction detail pages contain references specific to that interaction. You can click on the reference number within brackets '[]' to see what reference was utilized.
The information posted is fact-checked by HelloPharmacist clinicians and reviewed quarterly.