Abiraterone Acetate and Acetaminophen And Codeine: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 1, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Acetaminophen And Codeine
Abiraterone Acetate
How we grade severity & evidence
Severity levels
- Contraindicated: These should generally not be used together.
- Major: Potentially serious — often needs a change or close monitoring.
- Moderate: Can be significant — usually manageable with monitoring.
- Minor: Usually limited clinical impact.
Evidence grades
- Established: Well documented — supported by controlled studies or strong clinical data.
- Probable: Good supporting evidence, though not definitively proven.
- Suspected: Some evidence suggests this interaction, but it is not well established.
- Possible: Limited or conflicting evidence; the interaction may occur.
- Theoretical: Predicted from the drugs' pharmacology; not yet confirmed in people.
Ratings come from the documented interaction literature and are reviewed by a pharmacist. They describe the documented risk of the combination, not what will necessarily happen to you — your dose, timing, and health picture all matter.
Here's what's going on with these two medicines. Codeine is a prodrug, which means it doesn't work until your body converts it into morphine, the part that actually relieves pain. Your body uses an enzyme called CYP2D6 to make that change. Abiraterone can block that enzyme, so less codeine turns into morphine.
The likely result is that your codeine may not relieve pain as well while you take both. This concern is mostly theoretical, so please don't worry or change anything on your own. Keep taking both as prescribed, and let your care team know if your pain isn't well controlled. They can adjust things safely.
Mechanism: Abiraterone inhibits CYP2D6, the enzyme that O-demethylates codeine (a prodrug) to morphine, its active metabolite.
Direction/effect: Increased parent codeine exposure with reduced morphine formation, potentially causing analgesic failure or opioid withdrawal.
- Evidence: Theoretical; magnitude not quantified.
- Onset: Unspecified.
- Severity on file: Major.
- Management: If co-administered, monitor for inadequate analgesia and withdrawal; the codeine dose may need to be individualized upward by the care team. When abiraterone is discontinued, anticipate increased morphine formation, so the codeine dose may need reduction with monitoring for sedation and respiratory depression.
What happens
Increased codeine exposure and reduced active metabolite (morphine) exposure
Interaction Deep Dive
Concomitant use of codeine and a CYP2D6 inhibitor may reduce plasma concentrations of morphine, the active metabolite of codeine, thus potentially leading to reduced efficacy and withdrawal symptoms. If concomitant use is necessary, monitor patients for withdrawal symptoms and consider increasing the codeine dose. Once the CYP2D6 inhibitor is discontinued, consider reducing the codeine dose and monitor for signs and symptoms of respiratory depression and sedation312.
Why it happens (mechanism)
Inhibition of CYP2D6-mediated codeine metabolism
How to manage this interaction
Good news: your care team can manage this by tailoring your treatment and watching how you respond.
- Keep taking both exactly as prescribed unless your prescriber tells you otherwise.
- Tell your team if your pain is not well controlled or if you feel restless, sweaty, or achy (possible signs of reduced effect). Your codeine dose may need to be adjusted and individualized by your care team.
- Let them know if the abiraterone is ever stopped, since your codeine dose may then need to be lowered, and they may monitor you more closely for heavy sedation or slowed breathing.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Abiraterone Acetate and Acetaminophen And Codeine together?
Abiraterone can block the enzyme that turns codeine into morphine, so your codeine pain relief may be weaker while taking both. Keep taking them as prescribed and tell your care team if your pain isn't controlled, so they can adjust and monitor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Abiraterone Acetate and Acetaminophen And Codeine interaction?
It is rated major. Potentially serious — often needs a change or close monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Abiraterone Acetate and Acetaminophen And Codeine interaction managed?
Good news: your care team can manage this by tailoring your treatment and watching how you respond. Keep taking both exactly as prescribed unless your prescriber tells you otherwise. Tell your team if your pain is not well controlled or if you feel restless, sweaty, or achy (possible signs of reduced effect). Your codeine dose may need to be adjusted and individualized by your care team. Let them… Management is individual — always follow your own care team's guidance.
How strong is the evidence for this interaction?
The evidence is graded "theoretical". Predicted from the drugs' pharmacology; not yet confirmed in people.
Questions for your pharmacist
- Does my dose of Abiraterone Acetate or Acetaminophen And Codeine need adjusting while I take them together?
- What symptoms should prompt me to call you or my prescriber right away?
- Does the timing of my doses matter for this combination?
- Is there a safer alternative to one of these medications for me?
References (3)
- Product Information: Codeine sulfate oral solution, codeine sulfate oral solution. Hikma Pharmaceuticals USA Inc(per FDA), Berkeley Heights, NJ, 2023. DailyMed
- Product Information: Codeine sulfate oral tablets, codeine sulfate oral tablets. Hikma Pharmaceuticals USA Inc. (per FDA), Berkeley Heights, NJ, 2023. DailyMed
- Product Information: codeine sulfate oral tablets, codeine sulfate oral tablets. West-Ward Pharmaceuticals Corp. (per FDA), Eatontown, NJ, 2017. DailyMed
Keep reading about Acetaminophen And Codeine
Keep reading about Abiraterone Acetate
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major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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