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What not to mix

Interactions

Alcohol, benzodiazepines, sleep meds, and other opioids can stack with morphine and stop breathing.

Highest-risk combinations

  • Alcohol
  • Benzodiazepines (examples: alprazolam, diazepam, lorazepam)
  • Sleeping pills and other sedatives
  • Other opioids, including cough syrups that contain them
  • Muscle relaxers

Other clinically important interactions

  • MAO inhibitors (or within 14 days of stopping them) — risk of serotonin syndrome and exaggerated opioid effects
  • Mixed agonist/antagonist opioids (nalbuphine, butorphanol, pentazocine) can reduce pain relief and trigger withdrawal
  • Anticholinergic drugs increase constipation and urinary retention, and can lead to ileus
  • P-glycoprotein inhibitors (example: quinidine) can raise morphine exposure