Drug interactions
Codeine + Pregabalin
Severity: Major
Codeine and Pregabalin: 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
Pregabalin combined with opioids increases sedation and the risk of respiratory depression, particularly in the elderly and those with respiratory disease. Fatal overdoses involving both have been described.
What this interaction means in plain words
Codeine and Pregabalin 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; Pregabalin belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depressant effects.
What to do
Use the lowest effective doses and titrate slowly. Monitor for sedation and respiratory depression, especially at initiation and after dose increases.
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 Pregabalin
Frequently asked questions
Can I take Codeine with Pregabalin?
MediHelp rates the interaction as major. Codeine and Pregabalin 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. Pregabalin combined with opioids increases sedation and the risk of respiratory depression, particularly in the elderly and those with respiratory disease. Fatal overdoses involving both have been described.
How serious is the interaction between Codeine and Pregabalin?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and titrate slowly. Monitor for sedation and respiratory depression, especially at initiation and after dose increases.
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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