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Benzodiazepines

Also indexed as: Ativan®, Bromazepam, Centrax®, Chlorazepate, Chlordiazepoxide, Clonazepam, Dalmane®, Diastat®, Diazepam, Dizac™, Doral®, Estrazolam, Flunitrazepam, Flurazepam, Halazepam, Klonopin®, Libritabs®, Librium®, Loprazolam, Lorazepam, Lormetazepam, Midazolam, Nitrazepam, Paxipam®, Prazepam, ProSom®, Quazepam, Restoril®, Temazepam, Valium®, Versed®

Benzodiazepines are a family of drugs used to treat insomnia, anxiety, panic attacks, muscle spasms, and seizure disorders. One benzodiazepine, midazolam, is used as a general anesthetic.

Interactions involving benzodiazepines in general are described on this page. For interactions involving a specific benzodiazepine, refer to the highlighted drugs listed below.

Interactions with Dietary Supplements —

Vinpocetine
In a preliminary trial, an extract of periwinkle called vinpocetine was shown to produce minor improvements in short-term memory among people taking flunitrazepam, a benzodiazepine.1 Further study is needed to determine if vinpocetine would be a helpful adjunct to use of benzodiazepines.

Interactions with Herbs —

Kava (Piper methysticum)
Kava is an herb used to treat anxiety disorder. One individual who took a benzodiazepine (alprazolam) and kava together, along with two other medications (cimetidine and terazosin) was hospitalized in a lethargic and disoriented condition.2 Further research is needed to determine whether the combination of kava and benzodiazepines produces an adverse interaction. However, individuals should not take benzodiazepines and kava together unless supervised by a doctor.

Interactions with Foods and Other Compounds

Alcohol
Drinking alcoholic beverages while taking benzodiazepines may increase side effects, such as drowsiness, confusion, and dizziness;3 if taken in excess, this combination may result in death. Consequently, people taking benzodiazepines should avoid drinking alcohol.

Summary of Interactions for Benzodiazepines

Depletion or interference None known
Adverse interaction Alcohol
Side effect reduction/prevention None known
Supportive interaction Vinpocetine
Reduced drug absorption/bioavailability None known
Interactions common to many, if not all, Benzodiazepines are described in this article. Interactions reported for only one or several drugs in this class may not be listed in this article. Some drugs listed in this article are linked to articles specific to that respective drug; please refer to those individual drug articles. The information in this article may not necessarily apply to drugs in this class for which no separate article exists. If you are taking a Benzodiazepine for which no separate article exists, talk with your doctor or pharmacist.

For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.

References:

1. Bhatti JZ, Hindmarch I. Vinpocetine effects on cognitive impairments produced by flunitrazepam. Int Clin Psychopharmacol 1987;2:325–31.

2. Almeida JC. Coma from the health food store: Interaction between kava and alprazolam. Ann Intern Med 1996;125:940–1.

3. Olin BR, ed. Central Nervous System Drugs, Psychotherapeutic Drugs, Antianxiety Agents, In Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons, 1993, 1255–69.