Drug interactions
Codeine + Ziconotide
Severity: Moderate
Codeine and Ziconotide: 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
Ziconotide, given intrathecally, causes dose-related sedation, confusion and cognitive impairment. Concomitant opioids may add to CNS depression, although opioids are often used alongside ziconotide in practice.
What this interaction means in plain words
Codeine and Ziconotide 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; Ziconotide belongs to Central Nervous System.
Why it happens
Additive CNS depressant effects; ziconotide blocks N-type calcium channels while codeine acts at opioid receptors.
What to do
Monitor for sedation, confusion and altered mental status, and reduce the dose of either agent if these occur. Stop ziconotide if serious cognitive impairment develops.
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 Codeine
- Alvimopan + Codeine Contraindicated
- Codeine + Isocarboxazid Contraindicated
- Codeine + Olanzapine / samidorphan Contraindicated
- Codeine + Phenelzine Contraindicated
- Codeine + Tranylcypromine Contraindicated
- Alfentanil + Codeine Major
Other interactions of Ziconotide
- Clozapine + Ziconotide Major
- Alprazolam + Ziconotide Moderate
- Amitriptyline + Ziconotide Moderate
- Amobarbital + Ziconotide Moderate
- Aripiprazole + Ziconotide Moderate
- Armodafinil + Ziconotide Moderate
Frequently asked questions
Can I take Codeine with Ziconotide?
MediHelp rates the interaction as moderate. Codeine and Ziconotide 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. Ziconotide, given intrathecally, causes dose-related sedation, confusion and cognitive impairment. Concomitant opioids may add to CNS depression, although opioids are often used alongside ziconotide in practice.
How serious is the interaction between Codeine and Ziconotide?
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 for sedation, confusion and altered mental status, and reduce the dose of either agent if these occur. Stop ziconotide if serious cognitive impairment develops.
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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