Question: Combo of different pills.

[dj_]

Hi all, i am new here so i apologize if i have posted this in the wrong section.
My doctor has prescribed me a mix of different drugs and i didn't ask if any would interact with each other, i'm sure he would have mentioned it otherwise, but i do abuse what i am prescribed. (not entirely for recreational purposes, i really do need the codeine for pain for an unrelated matter, but after taking it for a couple of months, i have built up a tolerance)

I usually take around 180mg codeine, occasionally ill take 240mg codeine (i feel that is my limit, and any more would be too much for my body to cope with) (8x 30mg phosphate)
i have also been prescribed valium (5mg) i have abused this in the past for while, so i have a good understanding about both these drugs.
I have also been prescribed sertraline (anti depressant) i wont tell you my life story, but my question is this:

Is it ok to have my 50mg sertraline every morning, and after about half way through my working day i usually take the 180/210mg codeine. Is this going to be safe to do? Are the any interrations i should be aware of? I will also be taking the valium with the codeine, another thing i haven't tried.

Any comments will be of much help and appreciation!

 

[Swimmingdancer]

Hi dj_

It's good to ask, doctors don't always know about or inform people about drug interactions, and if you are taking more than prescribed that makes a difference. It's possible your doctor may have considered the interactions not very significant when the drugs are taken as prescribed and because you have a tolerance to the codeine, but it's also possible he/she wasn't aware or forgot. Plus some people may be more sensitive to interactions than others. I feel it's always best to do your own research so you can be fully informed about any drugs you are RXed before you take them. Especially if you are planning to take them differently than prescribed. Did your doctor tell you to start with lower doses of the 2 newly prescribed drugs and then gradually increase the dose?

There is an interaction between codeine and diazepam (Valium). They are both CNS depressants so sedation, respiratory depression and other effects may be increased (more than additively) if you take more than one CNS depressant, which can be very dangerous (mixing opioids and benzos is one of the biggest causes of overdoses). How safe it is really depends on your tolerance and how much of each drug you take. It is best to start off with a lower dose of each drug until you can gauge the effects. Or at least begin with your usual codeine dose (not one of your occasionally higher doses) and a lower dose of the Valium.

There is a small interaction between sertraline and codeine, because sertraline inhibits the enzyme which converts codeine into morphine, CYP2D6. This may slightly decrease some of the effects of the codeine, depending on the person.

There is a small interaction between sertraline and diazepam, as it can decrease the removal of diazepam from the body, may make it last longer, may make the diazepam take longer to peak or may increase its effects, or make it build up in the body more.

I would be especially careful if you are going to take the codeine, diazepam and sertraline all fairly close together, and especially if you need to be functional for work.

 

[tokenname]

i don't believe it to be dangerous..
but you should know that setraline can inhibit the analgesic
quality you receive from the codeine.
yay for those funny liver enzymes.
i'm supposed to say not to mix opiates with benzos now.
check.
just please be careful and keep the benzo dose low.
good luck.

edit: i got ninja'd. swimmingdancer always wins

 

[dj_]

Thanks so much swimmingdancer! I'm learning a lot here. I did a bit of research using google but didn't get anything like what you have written. I guess ill just take the sertraline in the morning, take my codeine in the afternoon and take the diazepam in the evening, shouldn't be too much to worry about then. Bit of a shame that the sertraline affects the codeine taking away its potency
Again thanks for you time guys i do appreciate this :D