Editing Benzodiazepine (section)

==Interactions==
Individual benzodiazepines may have different [[drug interaction|interactions]] with certain drugs. Depending on their [[metabolism]] pathway, benzodiazepines can be divided roughly into two groups. The largest group consists of those that are metabolized by [[cytochrome P450]] (CYP450) enzymes and possess significant potential for interactions with other drugs. The other group comprises those that are metabolized through [[glucuronidation]], such as [[lorazepam]], [[oxazepam]], and [[temazepam]], and, in general, have few drug interactions.<ref name="isbn0-444-50998-4">{{cite book |veditors=Meyler L, Aronson JK |title=Meyler's Side Effects of Drugs: the International Encyclopedia of Adverse Drug Reactions and Interactions |edition=15th |publisher=Elsevier |year=2006 |pages=429–443 |isbn=978-0-444-50998-7 }}</ref>

Many drugs, including [[combined oral contraceptive pill|oral contraceptives]], some [[antibiotic]]s, [[antidepressant]]s, and [[Antifungal medication|antifungal]] agents, inhibit cytochrome enzymes in the liver. They reduce the rate of elimination of the benzodiazepines that are metabolized by CYP450, leading to possibly excessive drug accumulation and increased side-effects. In contrast, drugs that induce cytochrome P450 enzymes, such as [[Hypericum perforatum|St John's wort]], the antibiotic [[rifampicin]], and the [[anticonvulsants]] [[carbamazepine]] and [[phenytoin]], accelerate elimination of many benzodiazepines and decrease their action.<ref name="isbn1-58829-211-8"/><ref name="biadmtad">{{cite journal | vauthors = Norman TR, Ellen SR, Burrows GD | title = Benzodiazepines in anxiety disorders: managing therapeutics and dependence | journal = The Medical Journal of Australia | volume = 167 | issue = 9 | pages = 490–495 | year = 1997 | pmid = 9397065 | url = http://www.mja.com.au/public/mentalhealth/course/06norman.pdf | doi = 10.5694/j.1326-5377.1997.tb126684.x | s2cid = 35852993 | archive-date = 13 June 2001 | access-date = 11 December 2008 | archive-url = https://web.archive.org/web/20010613084333/http://www.mja.com.au/public/mentalhealth/course/06norman.pdf | url-status = dead }}</ref> Taking benzodiazepines with alcohol, [[opioid]]s and other [[depressant|central nervous system depressants]] potentiates their action. This often results in increased sedation, impaired motor coordination, suppressed breathing, and other adverse effects that have potential to be lethal.<ref name="isbn1-58829-211-8">{{cite book |author=Moody D |veditors=Raymon LP, Mozayani A |title=Handbook of Drug Interactions: a Clinical and Forensic Guide |publisher=Humana |year=2004 |pages=[https://archive.org/details/handbookofdrugin0000unse/page/3 3–88] |chapter=Drug interactions with benzodiazepines |isbn=978-1-58829-211-7 |chapter-url-access=registration |chapter-url=https://archive.org/details/handbookofdrugin0000unse |url=https://archive.org/details/handbookofdrugin0000unse/page/3 }}</ref><ref name=biadmtad/> [[Antacids]] can slow down absorption of some benzodiazepines; however, this effect is marginal and inconsistent.<ref name="isbn1-58829-211-8"/>