Drug interactions
Codeine + Rasagiline
Severity: Major
Codeine and Rasagiline: major interaction.
Last updated Sources: UK SmPC
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
Rasagiline is an irreversible MAO-B inhibitor, and combining it with opioids has been associated with serotonin syndrome and other severe reactions. Labeling advises caution or avoidance with opioids.
What this interaction means in plain words
Codeine and Rasagiline 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; Rasagiline belongs to Central Nervous System.
Why it happens
MAO inhibition combined with the serotonergic and CNS depressant effects of codeine may cause serotonin toxicity.
What to do
Prefer a non-serotonergic analgesic. If both are required, monitor for agitation, hyperthermia, autonomic instability and sedation.
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 Rasagiline
- Atomoxetine + Rasagiline Contraindicated
- Brimonidine + Rasagiline Contraindicated
- Bupropion-naltrexone + Rasagiline Contraindicated
- Bupropion + Rasagiline Contraindicated
- Clomipramine + Rasagiline Contraindicated
- Desvenlafaxine + Rasagiline Contraindicated
Frequently asked questions
Can I take Codeine with Rasagiline?
MediHelp rates the interaction as major. Codeine and Rasagiline 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. Rasagiline is an irreversible MAO-B inhibitor, and combining it with opioids has been associated with serotonin syndrome and other severe reactions. Labeling advises caution or avoidance with opioids.
How serious is the interaction between Codeine and Rasagiline?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Prefer a non-serotonergic analgesic. If both are required, monitor for agitation, hyperthermia, autonomic instability and sedation.
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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