Drug interactions
Amitriptyline + Codeine
Severity: Moderate
Amitriptyline and Codeine: moderate interaction.
Last updated
For healthcare professionals — reference only. This page is a brief summary, not medical advice and not a substitute for official labeling or clinical judgement. Always verify before prescribing or dispensing.
Summary
Both agents cause sedation, so combined use can increase drowsiness, cognitive impairment and respiratory depression. Amitriptyline also has weak CYP2D6 inhibition, which may alter codeine activation.
What this interaction means in plain words
Amitriptyline and Codeine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken.
Amitriptyline belongs to Central Nervous System; Codeine belongs to Musculoskeletal.
Why it happens
Additive CNS depression, with possible CYP2D6 inhibition by amitriptyline.
What to do
Start with low doses and monitor sedation and respiratory status. Reassess analgesic effect.
What to ask your pharmacist
- Should I take them at different times of day?
- Does the dose of either medicine need to change?
- Is there anything I should avoid, such as alcohol or certain foods, while on both?
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Other interactions of Codeine
- Alvimopan + Codeine Contraindicated
- Codeine + Isocarboxazid Contraindicated
- Codeine + Olanzapine / samidorphan Contraindicated
- Codeine + Phenelzine Contraindicated
- Codeine + Tranylcypromine Contraindicated
- Alfentanil + Codeine Major
Other interactions of Amitriptyline
- Amitriptyline + Isocarboxazid Contraindicated
- Amitriptyline + Methylene blue Contraindicated
- Amitriptyline + Phenelzine Contraindicated
- Amitriptyline + Pimozide Contraindicated
- Amitriptyline + Procarbazine Contraindicated
- Amitriptyline + Safinamide Contraindicated
Frequently asked questions
Can I take Amitriptyline with Codeine?
MediHelp rates the interaction as moderate. Amitriptyline and Codeine can affect each other. The combination is often manageable, but it may need a change of dose, a change of timing, or extra checks while both are taken. Both agents cause sedation, so combined use can increase drowsiness, cognitive impairment and respiratory depression. Amitriptyline also has weak CYP2D6 inhibition, which may alter codeine activation.
How serious is the interaction between Amitriptyline and Codeine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Start with low doses and monitor sedation and respiratory status. Reassess analgesic effect.
What other medicines interact with Codeine?
MediHelp also lists interactions of Codeine with, for example, Alvimopan, Isocarboxazid, Olanzapine / samidorphan. The full list is on the Codeine page.
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