Drug interactions
Codeine + Elvitegravir / cobicistat / emtricitabine / tenofovir df
Severity: Moderate
Codeine and Elvitegravir / cobicistat / emtricitabine / tenofovir df: 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
Cobicistat inhibits CYP2D6, which converts codeine to morphine, so morphine formation may fall and analgesia may weaken. Cobicistat also inhibits CYP3A4, which may shift codeine toward other pathways and raise parent drug levels, so the net effect is uncertain.
What this interaction means in plain words
Codeine and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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.
Why it happens
Cobicistat inhibition of CYP2D6 (and CYP3A4) alters codeine metabolism and active metabolite formation.
What to do
Monitor analgesic response and for opioid toxicity such as sedation and respiratory depression. Consider a non-CYP2D6-dependent analgesic if pain control is inadequate.
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
Frequently asked questions
Can I take Codeine with Elvitegravir / cobicistat / emtricitabine / tenofovir df?
MediHelp rates the interaction as moderate. Codeine and Elvitegravir / cobicistat / emtricitabine / tenofovir df 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. Cobicistat inhibits CYP2D6, which converts codeine to morphine, so morphine formation may fall and analgesia may weaken. Cobicistat also inhibits CYP3A4, which may shift codeine toward other pathways and raise parent drug levels, so the net effect is uncertain.
How serious is the interaction between Codeine and Elvitegravir / cobicistat / emtricitabine / tenofovir df?
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 analgesic response and for opioid toxicity such as sedation and respiratory depression. Consider a non-CYP2D6-dependent analgesic if pain control is inadequate.
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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