Combinations - klonopins + codeine, is she in trouble? OD?

[Chuck]

I'm in Canada, my sister is in TX. I just called her and she sounded like she was on the verge of a coma. She was asleep when I called and it took about 5 min of me yelling at her thru the phone before she woke up enough to make any sense. she said she took 2 klonopins (I don't know what mg but she said it was the smallest one, might be lieing) and some cough syrup (I believe codeine). She weighs 100lbs. I normally wouldn't worry about something like this because the dose sounds low and she does stuff like this all the time and SWIM used to do way harder stuff, but it just didn't feel right. I'm debating whether to call my mother and have her take my sister to the hospital. i told my sister I wouldn't rat her out and I really don't want to rat her out because it's taken me years to earn her trust to the point where she would even tell me what she's on. what should I do?

P.S. I called the poison control hotline and they said she should be rushed to the hospital because her central nervous system could shut down or her heart could stop. I'm pretty sure they would say the same thing about inhaling a point-blank-range fart though.

[fnord]

2mg klonopin is not enough to cause anyone to OD,however without knowing how much codine was injested no one can say for certian. My gut insticnt is that shes probably fine but that you should take any avaibnle course of action to get her medical help.

[Gradient]

Your well-placed concern for your sister is understandable. However, any individual, without a tolerance, under 120 lbs. ingesting 2 mg of clonazepam will likely be knocked out pretty soundly for a good 10 hours, with some expected slurring of speech beforehand. I would be surprised if someone on such a high dose for that weight would have the presence of mind to ingest enough cough syrup to cause fatal effects - I would expect them to be intoxicated pretty quickly, and asleep soon thereafter. SWIM weighs about 150 lbs, and a 2 mg dose causes unavoidable lethargy and calmness, forgetfulness, and apathy. While the maximum daily recommended dose is 20 mg, this is not a value appropriate for a 100 lbs female.
Depending on the cough syrup, of course, it would generally take a large amount to directly cause a fatality. SWIM is fairly familiar with pharmacology, and has never read of any dangerous cross-potentiation of codeine and clonazepam taken concurrently. Clonazepam is a GABAa agonist while codeine (converted to morphine in the body) is primarily a mu-opoid agonist. Opiate-fatalities are generally respiratory problems, and a codeine induced respiratory failure would require a very large dose unlikely present in the syrup. Your sister would likely be facing more hazardous effects from high dose of the acetaminophen that is likely in the cough syrup - again though, she likely didn't drink enough to cause a fatality. The maximum acetaminophen that the average human liver can tolerate is 4000 mg, and the maximum recommended dose of codeine is nowhere near what your sister likely consumed.

The primary issue to address is whether your sister takes clonazepam regularly. If she does, then the intoxication may be cause for more concern. The hospital shouldn't be necessary, but some vomiting should be expected.

[Chuck]

Originally Posted by Gradient

Your well-placed concern for your sister is understandable. However, any individual, without a tolerance, under 120 lbs. ingesting 2 mg of clonazepam will likely be knocked out pretty soundly for a good 10 hours, with some expected slurring of speech beforehand. I would be surprised if someone on such a high dose for that weight would have the presence of mind to ingest enough cough syrup to cause fatal effects - I would expect them to be intoxicated pretty quickly, and asleep soon thereafter. SWIM weighs about 150 lbs, and a 2 mg dose causes unavoidable lethargy and calmness, forgetfulness, and apathy. While the maximum daily recommended dose is 20 mg, this is not a value appropriate for a 100 lbs female.
Depending on the cough syrup, of course, it would generally take a large amount to directly cause a fatality. SWIM is fairly familiar with pharmacology, and has never read of any dangerous cross-potentiation of codeine and clonazepam taken concurrently. Clonazepam is a GABAa agonist while codeine (converted to morphine in the body) is primarily a mu-opoid agonist. Opiate-fatalities are generally respiratory problems, and a codeine induced respiratory failure would require a very large dose unlikely present in the syrup. Your sister would likely be facing more hazardous effects from high dose of the acetaminophen that is likely in the cough syrup - again though, she likely didn't drink enough to cause a fatality. The maximum acetaminophen that the average human liver can tolerate is 4000 mg, and the maximum recommended dose of codeine is nowhere near what your sister likely consumed.

The primary issue to address is whether your sister takes clonazepam regularly. If she does, then the intoxication may be cause for more concern. The hospital shouldn't be necessary, but some vomiting should be expected.

She doesn't have a prescription for the klonopins, that was recreational. she got them from someone else and as far as I know she might do that once every couple of weeks. Im pretty sure that she only took the reccomended dose of codeine because that's legit (she has strep throat) and my mom gave it to her. I called her again a little while ago and she was easier to wake up and made more sense. I made her talk to me for a while so I think she is OK, and I was just paranoid.

[OsCarwild]

The lowest dosage that klonopin comes in is .25 mg... Taking two of those would only give someone half a milligram of it which should definitely not be enough to cause a sever problem when mixed with a proper dosage of codeine.

[Gradient]

When an individual has ingested an unknown dose of a given pharmaceutical but a known unit of tablets/quantity, it is generally safest to assume that the largest available dose has been ingested in order to successfully obviate any potentially treatable fatal overdoses.
OsCarwild, I'm generally inclined to agree - nothing was likely to come of her sister's experience. Just in the off chance that her sister was indeed over-dosing, it seemed best to provide any information that may have been of aid. She likely didn't come to the forum to just be calmed down, but to actually glean information.