Drug interactions
Codeine + Doxepin
Severity: Moderate
Codeine and Doxepin: 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
Doxepin is a sedating tricyclic antidepressant, and with codeine it can increase drowsiness, psychomotor impairment and respiratory depression. Doxepin may also inhibit CYP2D6 weakly, possibly reducing codeine activation, and serotonergic or anticholinergic effects can add.
What this interaction means in plain words
Codeine and Doxepin 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.
Codeine belongs to Musculoskeletal; Doxepin belongs to Dermatology.
Why it happens
Additive CNS depression, with possible weak CYP2D6 inhibition by doxepin reducing conversion of codeine to morphine.
What to do
Monitor sedation and analgesic response, and start with lower doses of either agent in older or frail patients. Counsel against driving until the response is known.
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 Doxepin
- Doxepin + Isocarboxazid Contraindicated
- Doxepin + Phenelzine Contraindicated
- Doxepin + Procarbazine Contraindicated
- Doxepin + Safinamide Contraindicated
- Doxepin + Selegiline Contraindicated
- Doxepin + Tranylcypromine Contraindicated
Frequently asked questions
Can I take Codeine with Doxepin?
MediHelp rates the interaction as moderate. Codeine and Doxepin 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. Doxepin is a sedating tricyclic antidepressant, and with codeine it can increase drowsiness, psychomotor impairment and respiratory depression. Doxepin may also inhibit CYP2D6 weakly, possibly reducing codeine activation, and serotonergic or anticholinergic effects can add.
How serious is the interaction between Codeine and Doxepin?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor sedation and analgesic response, and start with lower doses of either agent in older or frail patients. Counsel against driving until the response is known.
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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