Mixing Codeine (lean) and Zolpidem (Ambien)

Q: How dangerous is Codeine with Zolpidem?

Dangerous: High risk of death or life-changing injury. Do not combine.

Q: Is it safe to mix lean and Ambien?

MixSafe lists lean under Codeine and Ambien under Zolpidem. That combination is rated "Dangerous". Additive respiratory depression, made worse by codeine's unpredictable conversion. A dose that was fine last time can convert very differently alongside a drug that also alters liver metabolism.

Dangerous

Together they slow breathing, and codeine's strength is unpredictable.

Do this

Do not combine. Keep naloxone nearby.

General answer for Benzodiazepines: nothing specific to these two is documented.

Where the risk isTap for why

In an emergency, call 911911 Never Use Alone Poison Control

What to do

Say what was taken and how much.Responders need it, and in most US states Good Samaritan laws protect both of you from drug possession charges when you call for an overdose.
Unresponsive: put them on their side, tilt the head back, and stay until help arrives.Never leave someone alone to “sleep it off”.
Give naloxone (Narcan) if you have it.It is sold over the counter in every US state and does no harm if opioids turn out not to be involved.
Never Use Alone 1-800-484-3731Stays on the line and sends help if you stop responding.
Full steps: what to do if it is already happeningOverdose signs, the recovery position, what to say on the call, and whether you can be charged for making it.
Poison Control 1-800-222-1222Free and 24/7, for “is this bad?” before it becomes an emergency.

What “Dangerous” means

High risk of death or life-changing injury. Do not combine.

How the ratings work

The longer explanation

Additive respiratory depression, made worse by codeine's unpredictable conversion. A dose that was fine last time can convert very differently alongside a drug that also alters liver metabolism.

Sources (2)

Codeine Intoxication Associated with Ultrarapid CYP2D6 Metabolism. NEJMnejm.org
Codeine Therapy and CYP2D6 Genotype. Medical Genetics Summaries, NCBIncbi.nlm.nih.gov

Think this is wrong, or know a better source? Send it.

Other names

Codeine: lean, purple drank, co-codamol, dihydrocodeine; Weak, but metabolised unpredictably between people
Zolpidem: ambien, ambien cr, stilnox, edluar, intermezzo, zolpimist; Works like a benzo, plus sleepwalking and sleep-driving with no memory of it

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Related combinations

Codeine with

What not to mix with Codeine →

Zolpidem with

What not to mix with Zolpidem →

All combinations →

Can you mix Codeine (lean) and Zolpidem (Ambien)?

MixSafe rates mixing Codeine and Zolpidem as "Dangerous" — high risk of death or life-changing injury. Do not combine. No interaction specific to Codeine and Zolpidem is documented; this is the default for Benzodiazepines. Source: MixSafe research. Educational information, not medical advice.

This is a class-level answer, inherited from Benzodiazepines. Nothing specific to this exact pair is documented, so treat it as the default for the class rather than a measurement of these two drugs together.