Wednesday, February 6, 2008

Heath Ledger's Drug Interactions


According to the Chief Medical Examiner of New York, Heath Ledger "died as the result of acute intoxication by the combined effects of oxycodone (Percocet), hydrocodone (Vicodin), diazepam (Valium), temazepam (Restoril), alprazolam (Xanax), and doxylamine (Unisom)."

To illustrate why he died, the following is a list of potential drug interactions from Epocrates, an online drug database. Nearly everything interacted with everything else:

1. diazepam <-> oxycodone
caution advised, especially w/ IV benzodiazepines and IV opioids, consider dose reduction: combo may result in vasodilation, severe hypotension, CNS and respiratory depression, psychomotor impairment (additive effects)

2. diazepam <-> temazepam
caution advised: combo may incr. risk of CNS depression, adverse effects (additive effects)

3. diazepam <-> Vicodin
caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

4. diazepam <-> Xanax
caution advised: combo may incr. risk of CNS depression, adverse effects (additive effects)

5. oxycodone <-> temazepam
caution advised, especially w/ IV benzodiazepines and IV opioids, consider dose reduction: combo may result in vasodilation, severe hypotension, CNS and respiratory depression, psychomotor impairment (additive effects)

6. oxycodone <-> Vicodin
caution advised, consider dose reduction: combo may incr. risk of CNS and resp. depression, profound sedation, hypotension, other adverse effects (additive effects)

7. oxycodone <-> Xanax
caution advised, especially w/ IV benzodiazepines and IV opioids, consider dose reduction: combo may result in vasodilation, severe hypotension, CNS and respiratory depression, psychomotor impairment (additive effects)

8. temazepam <-> Vicodin
caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

9. temazepam <-> Xanax
caution advised: combo may incr. risk of CNS depression, adverse effects (additive effects)

10. Vicodin <-> Xanax
caution advised: combo may incr. risk of CNS depression, psychomotor impairment (additive effects)

3 comments:

Megan said...

As a lay(wo)man, I must thank you for this post. My husband's 26 yr old cousin died this past year from a seemingly fatal combination of prescription drugs. While the toxicology reports were technically inconclusive, some of the drugs found in his system are the same as in this list. It's interesting and helpful to have the individual drug interactions parsed out in this way.

Huck said...

More simply put:

He took two morphine like drugs (oxycodone and hydrocodone) and 4 valium like drugs (the -pams).
Combining 1 from column A and 1 from column B is potentially a recipe for disaster.

Unfortunately the pharmacology soup he took was lethal. He probably had no clue what he was mixing.

Johnson said...

A new, powerful drug-drug interaction checker is available on eHealthMe (www.ehealthme.com). What sets this checker apart from others are its results are analyzed from millions of constantly updated drug reports.

Right now on eHealthMe people can get:
1. most reported drug interactions and side effects
2. potential interacting drugs

Hope this helps.