Can You Take Zopiclone with Codeine?
Last reviewed: · Source: US FDA drug label database
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Zopiclone plus codeine combines two central nervous system depressants — the pairing risks dangerously suppressed breathing during sleep and should be avoided.
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Is it safe to take Zopiclone with Codeine?
Zopiclone is a Z-drug sleeping tablet and codeine is an opioid painkiller. Both suppress the central nervous system and — critically — the brain's respiratory drive. Zopiclone acts via GABA-A receptors; codeine is converted to morphine, which activates mu-opioid receptors in the medullary respiratory centres. Together the suppression of breathing is synergistic: greater than the sum of either drug alone. This risk is highest during sleep, when the normal physiological safeguards against breathing failure (the hypoxic arousal response) are already suppressed. The combination has caused confirmed fatalities and is specifically mentioned in NHS guidance on Z-drug and opioid co-prescribing. The practical point: co-codamol products available over the counter (such as Solpadol, Kapake, or generic co-codamol 8/500) must not be combined with a prescribed zopiclone sleeping tablet. For pain relief on nights when you take zopiclone, use paracetamol alone — it has no CNS depressant effect and is completely safe alongside zopiclone.
How do Zopiclone and Codeine interact?
Zopiclone potentiates GABA-A receptor inhibition; codeine's metabolite morphine agonises mu-opioid receptors in the medullary respiratory centres. Combined GABAergic and opioid respiratory depression is synergistic and most dangerous during sleep, when arousal responses to hypoxia and hypercapnia are already blunted.
Data sourced from the US Food and Drug Administration (FDA) drug label database: OpenFDA zopiclone/eszopiclone class labelling — CNS depressant co-administration warnings.
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Everyone — particularly people with sleep apnoea or snoring, COPD or asthma, the elderly, ultra-rapid codeine metabolisers, and anyone who has consumed alcohol the same evening.
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What if I've already taken Zopiclone and Codeine?
If you've taken both tonight, do not take any more of either, avoid alcohol completely, and ideally have someone aware who can check on you. Seek emergency help for very slow breathing, unrousable sleepiness, or blue lips. Longer term, ask your GP to review — pain and insomnia can usually be managed with a safer plan.
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Not sure if this combination is safe for your specific situation?
HealthLabs.com lets you check liver enzyme or kidney function levels before combining medications long-term — no GP referral needed.
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Frequently Asked Questions
Can I take zopiclone and codeine together?
No — zopiclone and codeine should not be combined without explicit prescriber instruction. Both suppress the CNS and breathing. Together they cause synergistic respiratory depression during sleep, which can be fatal. Deaths from this combination are documented.
What happens if you take zopiclone and codeine?
Both depress the brain's breathing control centre — zopiclone via GABA-A receptors, codeine (converted to morphine) via mu-opioid receptors. The combined suppression of breathing is synergistic and highest risk overnight when normal arousal responses to low oxygen are already blunted.
Can I take co-codamol with zopiclone?
No. Co-codamol contains codeine and must not be combined with zopiclone. Use paracetamol alone (without codeine) for pain on nights you take zopiclone.
What painkillers are safe with zopiclone?
Paracetamol is the safest — no CNS depressant effect. Ibuprofen is also acceptable for most people. Codeine, tramadol, and other opioids must be avoided.
What are the emergency warning signs?
Very slow or shallow breathing, deep gurgling snoring that cannot rouse you, blue-tinged lips. These are emergencies — call 999 (UK) or 911 (US) immediately.
Can I take Nurofen Plus with zopiclone?
No. Nurofen Plus contains codeine which must not be combined with zopiclone. Use plain ibuprofen (without codeine) instead.
How long after codeine can I take zopiclone?
There is no safe waiting time within a single evening — codeine's active metabolite morphine stays in the body for hours. If you have taken codeine, do not take zopiclone that night.
Is zopiclone an opioid?
No — zopiclone is a Z-drug working on GABA-A receptors. But both opioids and Z-drugs suppress the CNS and breathing, so combining them carries the same fatal respiratory risk as opioid + benzodiazepine combinations.