.
Combination drugs: Empirin® with Codeine, Fiorinal®, Phenergan® VC with Codeine, Phenergan® with Codeine, Robitussin® AC, Soma® Compound with Codeine, Tylenol® with Codeine
Codeine is a narcotic analgesic (pain reliever) derived from opium. It is used alone and in combination products to treat mild to moderate pain and as a cough suppressant.
Interactions with Herbs
Tannin-containing herbs
Tannins are a group of unrelated chemicals that give plants an astringent taste. Herbs with
large amounts of tannins may interfere with the absorption of codeine and should not be taken
together with codeine or codeine-containing products.1 Herbs containing high levels
of tannins include green tea (Camellia sinensis),
black tea, uva ursi (Arctostaphylos uva-ursi),
black walnut (Juglans nigra),red
raspberry (Rubus idaeus),oak
(Quercus spp.), and witch hazel (Hamamelis
virginiana).
Interactions with Foods and Other Compounds
Food
Codeine commonly causes gastrointestinal (GI) upset. Codeine and codeine-containing products
may be taken with food to reduce or prevent GI upset.2 A common side effect of
narcotic analgesics, including codeine, is
constipation. Increasing dietary fiber (fruits,
vegetables, beans, whole-grain foods, and others) and water intake can ease constipation.
Alcohol
Alcohol causes a loss of coordination, impaired judgment, decreased alertness, drowsiness, and
other actions. Narcotic analgesics, including codeine, cause similar loss of control.
Combining codeine and alcohol increases the risk of accidental injury. People taking
codeine-containing products should avoid alcohol.
Summary of Interactions for Codeine
| Depletion or interference | None known |
|---|---|
| Adverse interaction | None known |
| Side effect reduction/prevention | None known |
| Supportive interaction | None known |
| Reduced drug absorption/bioavailability | Tannin-containing herbs* such as green tea, black tea, uva ursi, black walnut, red raspberry, oak, and witch hazel |
For the convenience of the reader, the information in the summary is categorized as follows: “Depletion or interference” indicates the drug may deplete or interfere with the absorption or function of the supplement or herb. “Adverse interaction” indicates that the supplement or herb used together with the drug may result in undesirable effects. “Side effect reduction/prevention” indicates the supplement or herb may reduce the likelihood and/or severity of a potential side effect caused by the drug. “Supportive interaction” indicates the supplement or herb may support or aid the function of the drug. “Reduced drug absorption/bioavailability” indicates that the supplement or herb may decrease the absorption and/or activity of the drug in the body. An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
References:
1. Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14–20.
2. Threlkeld DS, ed. Central Nervous System Drugs, Narcotic Agonist Analgesics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Feb 1990, 243d.
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