Drug interactions
Codeine + Linezolid
Severity: Major
Codeine and Linezolid: major interaction.
Last updated Sources: US FDA label
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
Linezolid is a weak reversible MAO inhibitor, and combining it with codeine may lead to serotonin toxicity or an MAOI-type opioid reaction with agitation, hyperthermia, autonomic instability and altered consciousness. The risk is uncertain for codeine but is serious enough to warrant caution.
What this interaction means in plain words
Codeine and Linezolid can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for.
Codeine belongs to Musculoskeletal; Linezolid belongs to Anti Bacterial.
Why it happens
Inhibition of monoamine oxidase by linezolid combined with opioid serotonergic activity may precipitate serotonin toxicity or an MAOI-opioid reaction.
What to do
Choose a non-serotonergic analgesic during linezolid therapy where possible. If concurrent use is unavoidable, monitor closely for signs of serotonin syndrome and stop the opioid if they appear.
What to ask your pharmacist
- Does the benefit of taking both outweigh the risk in my case?
- Do I need any blood test, ECG or other check while on both?
- What early warning signs should I watch for, and what should I do if they appear?
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References
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 Linezolid
- Amoxapine + Linezolid Contraindicated
- Atomoxetine + Linezolid Contraindicated
- Benzphetamine + Linezolid Contraindicated
- Brimonidine + Linezolid Contraindicated
- Bupropion-naltrexone + Linezolid Contraindicated
- Bupropion + Linezolid Contraindicated
Frequently asked questions
Can I take Codeine with Linezolid?
MediHelp rates the interaction as major. Codeine and Linezolid can interact in a way that may be serious. Using them together is sometimes necessary, but it needs a deliberate decision by the prescriber, a plan for monitoring, and clear advice on the warning signs to watch for. Linezolid is a weak reversible MAO inhibitor, and combining it with codeine may lead to serotonin toxicity or an MAOI-type opioid reaction with agitation, hyperthermia, autonomic instability and altered consciousness. The risk is uncertain for codeine but is serious enough to warrant caution.
How serious is the interaction between Codeine and Linezolid?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Choose a non-serotonergic analgesic during linezolid therapy where possible. If concurrent use is unavoidable, monitor closely for signs of serotonin syndrome and stop the opioid if they appear.
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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