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INTERACTION
Codeine base
CAS number 76-57-3
Codeine is the starting material and prototype of a large class of mainly
mild to moderately strong such as hydrocodone, dihydrocodeine and its
derivatives. Related to codeine in other ways are Codeine-N-Oxide , related
to the nitrogen morphine derivatives as is codeine methobromide, and
heterocodeine which is a drug six times stronger than morphine and 72 times
stronger than codeine due to a small re-arrangement of the molecule, viz.
moving the methyl group from the 3 to the 6 position on the morphine carbon
skeleton. Drugs bearing resemblance to codeine in effects due to close
structural relationship are variations on the methyl groups at the 3
position including ethylmorphine a.k.a. codethyline and benzylmorphine
. While having no narcotic effects of its own, the important opioid
precursor thebaine differs from codeine only slightly in structure.
Pseudocodeine and some other similar alkaloids not currently used in
medicine are found in trace amounts in opium as well.
Do not take codeine with other narcotic pain medications, sedatives,
tranquilizers, muscle relaxers, or other medicines that can make you sleepy
or slow your breathing. Dangerous side effects may result.
There may be other drugs that can interact with codeine. Tell your doctor
about all the prescription and over-the-counter medications you use. This
includes vitamins, minerals, herbal products, and drugs prescribed by other
doctors. Do not start using a new medication without telling your doctor.
Patients should also be cautioned about the combined effects of codeine with
other CNS depressants, including other , phenothiazines, sedative/hypnotics
and alcohol. The analgesic effect of codeine is potentiated by amphetamines,
chlorpromazine and methocarbamol. CNS depressants, such as other ,
anesthetics, sedatives, hypnotics, barbiturates, phenothiazines, chloral
hydrate and glutethimide may enhance the depressant effects of codeine. MAO
inhibitors (including procarbazine HCl), pyrazolidone antihistamines,
beta-blockers and alcohol may also enhance the depressant effect of codeine.
When combined therapy is contemplated, the dose of one or both agents should
be reduced.
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