Drug interactions
Codeine + Sertraline
Severity: Minor
Codeine and Sertraline: minor 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
Sertraline mildly to moderately inhibits CYP2D6, particularly at higher doses, and may reduce conversion of codeine to morphine. Analgesic benefit may be somewhat diminished. Both drugs also have serotonergic activity, although serotonin syndrome is uncommon with codeine.
What this interaction means in plain words
Codeine and Sertraline have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised.
Codeine belongs to Musculoskeletal; Sertraline belongs to Central Nervous System.
Why it happens
Sertraline weakly to moderately inhibits CYP2D6, reducing codeine activation.
What to do
Monitor analgesic response and consider switching to a non-CYP2D6-dependent opioid if pain control is poor. Watch for features of serotonin toxicity.
What to ask your pharmacist
- Is there anything I should notice while taking both?
- Do I need to tell my doctor at the next visit?
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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
Other interactions of Sertraline
- Isocarboxazid + Sertraline Contraindicated
- Methylene blue + Sertraline Contraindicated
- Phenelzine + Sertraline Contraindicated
- Pimozide + Sertraline Contraindicated
- Selegiline transdermal + Sertraline Contraindicated
- Selegiline + Sertraline Contraindicated
Frequently asked questions
Can I take Codeine with Sertraline?
MediHelp rates the interaction as minor. Codeine and Sertraline have a small, usually unimportant interaction. Most people can take both; the pharmacist may still mention it so that any unexpected effect is recognised. Sertraline mildly to moderately inhibits CYP2D6, particularly at higher doses, and may reduce conversion of codeine to morphine. Analgesic benefit may be somewhat diminished. Both drugs also have serotonergic activity, although serotonin syndrome is uncommon with codeine.
How serious is the interaction between Codeine and Sertraline?
MediHelp rates it minor, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Monitor analgesic response and consider switching to a non-CYP2D6-dependent opioid if pain control is poor. Watch for features of serotonin toxicity.
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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