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.
Summary of Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory. For clarification, read the full article for details about the summarized interactions.
 Avoid: Reduced drug absorption/bioavailability—Avoid these supplements when taking this medication since the supplement may decrease the absorption and/or activity of the medication in the body. | Tannin-containing herbs* such as green tea, black tea, uva ursi, black walnut, red raspberry, oak, and witch hazel |
| Depletion or interference | None known |
| Side effect reduction/prevention | None known |
| Supportive interaction | None known |
| Adverse interaction | None known |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
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.
References (To view, roll mouse over the "References" heading; to hide, click on the heading)
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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The information presented in Healthnotes is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires June 2009.