Drug Interaction Report

Acetaminophen And Codeine and Desmopressin: Interaction Details

AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jun 30, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Acetaminophen And Codeine

Capital® & Codeine Codrix® Empracet® (#3, #4) Papa-deine® (#3, #4) Phenaphen® with Codeine (#2, #3, #4) Proval® #3 Tylenol with Codeine Tylenol® with Codeine (#3, #4)
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Desmopressin

DDAVP Desmoda Nocdurna Noctiva
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jun 30, 2026
LinkedIn
Interaction severity
Moderate
Can be significant — usually manageable with monitoring.
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.

Of 489 documented Acetaminophen And Codeine interactions, 26 are rated moderate — including this one.
At a glance + Theoretical Effects may be stronger
The Bottom Line
Using codeine/acetaminophen with desmopressin may slightly raise the risk of low sodium from water retention, but this is theoretical and your care team can manage it with periodic sodium checks. Keep taking both as prescribed and report headache, nausea, or confusion.

You're taking desmopressin along with a codeine and acetaminophen pain medicine. Desmopressin works by helping your body hold on to water. Opioids like codeine can also nudge your body to keep more water. When both are used together, there's a chance that too much water builds up and your blood sodium level drops too low. This is called hyponatremia, and it can cause headaches, nausea, confusion, or feeling very tired.

This concern is mostly theoretical, so please don't worry. The good news is your care team can manage it easily, often just by checking your sodium with a simple blood test. Keep taking both medicines as prescribed, and let your pharmacist or doctor know if you feel off.

Effect: Additive risk of water retention leading to hyponatremia/water intoxication when an opioid (codeine/acetaminophen) is combined with desmopressin.

  • Mechanism: Unknown/theoretical; desmopressin is a vasopressin (V2) agonist promoting free-water retention, and opioids may potentiate ADH-like effects.
  • Direction/magnitude: Enhanced antidiuretic/PD effect; magnitude not quantified.
  • Onset: Unspecified.
  • Evidence: Theoretical.
  • Management: Monitor serum sodium more frequently during coadministration and after any dose increases; counsel on hyponatremia symptoms; consider fluid restriction per protocol.
Onset
unspecified
Evidence
theoretical
Severity
Moderate

What happens

Increased risk of water intoxication with hyponatremia

Interaction Deep Dive

Concomitant use of desmopressin and an opioid may increase risk of water intoxication with hyponatremia. If coadministration is required, monitor serum sodium more frequently with concomitant use and when doses are increased1.

Why it happens (mechanism)

Unknown

How to manage this interaction

This interaction can usually be managed well by your care team. Both medicines can often be continued together when needed.

  • Keep taking both as prescribed unless your prescriber tells you otherwise.
  • Your team may check your blood sodium more often, especially when you first combine them or when a dose is increased.
  • Watch for signs of low sodium: headache, nausea, muscle cramps, confusion, or unusual drowsiness.
  • Ask your pharmacist or doctor before making any changes, and report symptoms promptly.

Management is individual — confirm any change with your pharmacist or prescriber.

Common questions

Can I take Acetaminophen And Codeine and Desmopressin together?

Using codeine/acetaminophen with desmopressin may slightly raise the risk of low sodium from water retention, but this is theoretical and your care team can manage it with periodic sodium checks. Keep taking both as prescribed and report headache, nausea, or confusion. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Acetaminophen And Codeine and Desmopressin interaction?

It is rated moderate. Can be significant — usually manageable with monitoring.

How quickly could this interaction happen?

The documented onset is "unspecified". The timing of this interaction is not well characterized.

How is the Acetaminophen And Codeine and Desmopressin interaction managed?

This interaction can usually be managed well by your care team. Both medicines can often be continued together when needed. Keep taking both as prescribed unless your prescriber tells you otherwise. Your team may check your blood sodium more often, especially when you first combine them or when a dose is increased. Watch for signs of low sodium: headache, nausea, muscle cramps, confusion, or unusu… 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 Acetaminophen And Codeine or Desmopressin 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 anything you'd monitor while I'm on both?

References (1)

  1. Product Information: DESMODA™ oral solution, desmopressin acetate oral solution. Eton Pharmaceuticals, Inc. (Per FDA), Deer Park, IL, 2026. DailyMed
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This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.