Drug interactions
Codeine + Sodium oxybate
Severity: Major
Codeine and Sodium oxybate: 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
Sodium oxybate is a potent CNS depressant, and the combination with codeine can cause profound sedation, respiratory depression, coma and death. Concurrent use with opioids is cautioned in labeling.
What this interaction means in plain words
Codeine and Sodium oxybate 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; Sodium oxybate belongs to Central Nervous System.
Why it happens
Additive CNS and respiratory depression via GABA-B and GHB receptor effects and mu-opioid agonism.
What to do
Avoid where possible. If used together, minimize doses and monitor respiratory function and consciousness.
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 Sodium oxybate
- Alprazolam + Sodium oxybate Contraindicated
- Amobarbital + Sodium oxybate Contraindicated
- Butorphanol + Sodium oxybate Contraindicated
- Chloral hydrate + Sodium oxybate Contraindicated
- Clonazepam + Sodium oxybate Contraindicated
- Clorazepate + Sodium oxybate Contraindicated
Frequently asked questions
Can I take Codeine with Sodium oxybate?
MediHelp rates the interaction as major. Codeine and Sodium oxybate 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. Sodium oxybate is a potent CNS depressant, and the combination with codeine can cause profound sedation, respiratory depression, coma and death. Concurrent use with opioids is cautioned in labeling.
How serious is the interaction between Codeine and Sodium oxybate?
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 where possible. If used together, minimize doses and monitor respiratory function and consciousness.
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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