Codeine drug interactions

Adverse effects and drug interactions with codeine are similar to those reported for morphine, although they are less intense. Overdose in children results in the same effects as overdose of morphine, such as respiratory depression, miosis, and coma these symptoms are treated with naloxone administration. 

The opioids (e.g. codeine, dextromethorphan), NSAIDs, aspirin and paracetamol found in many over-the-counter drugs have the potential for adverse drug interactions. For more details, see Over-the-Counter Drugs. 

Caraco Y, Sheller J, Wood AJJ. Pharmacogenetic determination of the effects of codeine and prediction of drug interactions. J Pharmacol Exp Ther 1996 278(3) 1165-74. 

Amistrong AC, Cozza KL. Pharmacokinetic drug interactions of morphine, codeine, and their derivatives theory and clinical reality. Part I. Psychosomatics(200y) 44,167-71. 

The PE spectra of some other alkaloids like methadone and the opiate narcotics morphine, codeine and heroin have been investigated by Klasinc and coworkers95. Also in this study structure-activity relationships based on IPs were sought but not found. Since the interaction of the drug molecule with the receptor is highly specific, it is not unreasonable that the molecular rather than the electronic structure is more important for the physiological activity. 

Acetaminophen can interact with other drugs, both in good and bad ways. For example, hospitals often combine acetaminophen with the narcotic pain reliever codeine (CoTylenol ) to treat more severe pain. Caffeine can increase the effectiveness of acetaminophen similarly to the way it does with aspirin. Brand names that use a combination of aspirin, caffeine, and acetaminophen include Excedrin and Vanquish . Combining these ingredients for their additive effects also reduces the dose needed for each one and thereby reduces the risk of side effects. However, there are a few drugs that should not be mixed with acetaminophen. These include anticonvulsants and alcohol, both of which increase the risk of liver damage. 

Ammon S, von Richter O, Hofmann U, Thon KP, Eichelbaum M, Mikus G. In vitro interaction of codeine and diclofenac. Drug Metab Dispos (2000) 28, 1149-52. 

---