Drug interactions
Codeine + Rolapitant
Severity: Moderate
Codeine and Rolapitant: 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
Codeine is a prodrug activated by CYP2D6 to morphine. Rolapitant's CYP2D6 inhibition may reduce morphine formation and therefore analgesia, without increasing toxicity.
What this interaction means in plain words
Codeine and Rolapitant 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.
Codeine belongs to Musculoskeletal; Rolapitant belongs to Gastrointestinal Tract.
Why it happens
Rolapitant inhibits CYP2D6, reducing conversion of codeine to morphine.
What to do
Monitor pain control and consider a non-CYP2D6-dependent analgesic such as morphine. The effect may persist at least 28 days after rolapitant.
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 Rolapitant
- Pimozide + Rolapitant Contraindicated
- Rolapitant + Thioridazine Contraindicated
- Atomoxetine + Rolapitant Major
- Deutetrabenazine + Rolapitant Major
- Eliglustat + Rolapitant Major
- Flecainide + Rolapitant Major
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 Rolapitant?
MediHelp rates the interaction as moderate. Codeine and Rolapitant 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. Codeine is a prodrug activated by CYP2D6 to morphine. Rolapitant's CYP2D6 inhibition may reduce morphine formation and therefore analgesia, without increasing toxicity.
How serious is the interaction between Codeine and Rolapitant?
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 pain control and consider a non-CYP2D6-dependent analgesic such as morphine. The effect may persist at least 28 days after rolapitant.
What other medicines interact with Rolapitant?
MediHelp also lists interactions of Rolapitant with, for example, Pimozide, Thioridazine, Atomoxetine. The full list is on the Rolapitant page.
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