Drug interactions
Codeine + Zotepine
Severity: Moderate
Codeine and Zotepine: 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
Zotepine is a sedating antipsychotic that can add to opioid-related drowsiness, hypotension and respiratory depression. Zotepine also lowers seizure threshold, and opioids can add to that risk in susceptible patients.
What this interaction means in plain words
Codeine and Zotepine 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.
Why it happens
Additive CNS depression through opioid agonism and antipsychotic antihistaminergic and adrenergic blockade.
What to do
Use the lowest effective doses and monitor for sedation, hypotension and respiratory depression. Counsel the patient about alcohol and driving.
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
Frequently asked questions
Can I take Codeine with Zotepine?
MediHelp rates the interaction as moderate. Codeine and Zotepine 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. Zotepine is a sedating antipsychotic that can add to opioid-related drowsiness, hypotension and respiratory depression. Zotepine also lowers seizure threshold, and opioids can add to that risk in susceptible patients.
How serious is the interaction between Codeine and Zotepine?
MediHelp rates it moderate, on a four-level scale (minor, moderate, major, contraindicated) based on published labels and references. What to do, in brief: Use the lowest effective doses and monitor for sedation, hypotension and respiratory depression. Counsel the patient about alcohol and driving.
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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