Drug interactions
Codeine + Selegiline transdermal
Severity: Major
Codeine and Selegiline transdermal: 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
Selegiline is an MAO inhibitor, and combining MAOIs with opioids has been associated with serotonin syndrome and severe hypotensive or hyperpyrexial reactions. Transdermal selegiline for depression carries labeling that advises against such combinations.
What this interaction means in plain words
Codeine and Selegiline transdermal 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.
Why it happens
MAO inhibition combined with opioid serotonergic and CNS effects; the exact mechanism is not fully defined.
What to do
Avoid combination and choose another analgesic. If an opioid is unavoidable, monitor closely for serotonin syndrome, blood pressure changes 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
Frequently asked questions
Can I take Codeine with Selegiline transdermal?
MediHelp rates the interaction as major. Codeine and Selegiline transdermal 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. Selegiline is an MAO inhibitor, and combining MAOIs with opioids has been associated with serotonin syndrome and severe hypotensive or hyperpyrexial reactions. Transdermal selegiline for depression carries labeling that advises against such combinations.
How serious is the interaction between Codeine and Selegiline transdermal?
MediHelp rates it major, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Avoid combination and choose another analgesic. If an opioid is unavoidable, monitor closely for serotonin syndrome, blood pressure changes 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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