Drug interactions
Codeine + Protriptyline
Severity: Moderate
Codeine and Protriptyline: 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
Opioids combined with tricyclic antidepressants can produce additive sedation and psychomotor impairment. Tricyclics may also potentiate opioid-related respiratory depression, and protriptyline's anticholinergic effects can add to opioid constipation and urinary retention.
What this interaction means in plain words
Codeine and Protriptyline 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
Additive central nervous system depression, with possible serotonergic and anticholinergic contributions from the tricyclic.
What to do
Start with the lowest effective codeine dose and monitor for excessive sedation, respiratory depression and anticholinergic effects. Counsel the patient about driving and alcohol avoidance.
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 Protriptyline?
MediHelp rates the interaction as moderate. Codeine and Protriptyline 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. Opioids combined with tricyclic antidepressants can produce additive sedation and psychomotor impairment. Tricyclics may also potentiate opioid-related respiratory depression, and protriptyline's anticholinergic effects can add to opioid constipation and urinary retention.
How serious is the interaction between Codeine and Protriptyline?
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 the lowest effective codeine dose and monitor for excessive sedation, respiratory depression and anticholinergic effects. Counsel the patient about driving and alcohol avoidance.
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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