Drug interactions
Codeine + Selegiline
Severity: Major
Codeine and Selegiline: major interaction.
Last updated Sources: Health Canada product monograph
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-B inhibitor that becomes nonselective at higher doses, as with transdermal use, and combining it with opioids can cause serotonin syndrome or severe CNS and cardiovascular reactions.
What this interaction means in plain words
Codeine and Selegiline 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; Selegiline belongs to Central Nervous System.
Why it happens
MAO inhibition combined with opioid serotonergic and CNS depressant effects.
What to do
Avoid codeine with selegiline, particularly transdermal selegiline, and use a non-serotonergic analgesic. If unavoidable, monitor closely for serotonin toxicity 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 Selegiline
- Amitriptyline + Selegiline Contraindicated
- Amoxapine + Selegiline Contraindicated
- Atomoxetine + Selegiline Contraindicated
- Benzphetamine + Selegiline Contraindicated
- Brimonidine + Selegiline Contraindicated
- Buprenorphine long-acting + Selegiline Contraindicated
Frequently asked questions
Can I take Codeine with Selegiline?
MediHelp rates the interaction as major. Codeine and Selegiline 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-B inhibitor that becomes nonselective at higher doses, as with transdermal use, and combining it with opioids can cause serotonin syndrome or severe CNS and cardiovascular reactions.
How serious is the interaction between Codeine and Selegiline?
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 codeine with selegiline, particularly transdermal selegiline, and use a non-serotonergic analgesic. If unavoidable, monitor closely for serotonin toxicity 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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