Acetaminophen And Codeine and Pipenzolate Bromide: 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
Pipenzolate Bromide
No brand names on record
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.
Your pain medicine codeine (combined with acetaminophen) and pipenzolate bromide (a stomach antispasmodic) can both slow down how your gut moves. When you take them together, that slowing effect can add up. This may cause severe constipation or trouble emptying your bladder. In rare cases, the bowel can slow so much that it nearly stops, which is called a paralytic ileus.
This is a theoretical concern, so it may never cause you a problem. Still, it is worth watching for. If you notice bad constipation, belly bloating, or trouble urinating, let your doctor or pharmacist know. Your care team can manage this easily by keeping an eye on things.
Effect: Additive reduction in GI motility and increased risk of urinary retention, severe constipation, and potentially paralytic ileus.
Mechanism: Codeine (an opioid) decreases gut motility; pipenzolate bromide is an antimuscarinic anticholinergic that also slows GI transit and impairs bladder emptying. Effects are additive (PD interaction). Neither the analgesic nor the anticholinergic activity here depends on this pathway in a prodrug sense relevant to the interaction.
- Severity: Major
- Onset: Unspecified
- Evidence: Theoretical
Management: Monitor for constipation, abdominal distension, reduced bowel sounds, and urinary retention. Consider bowel regimen; dose may be individualized by the care team.
What happens
An increased risk of paralytic ileus
Interaction Deep Dive
When codeine is taken together with anticholinergic agents, the likelihood of urinary retention and/or severe constipation may rise, potentially resulting in paralytic ileus. During concurrent administration of codeine and anticholinergic drugs, watch patients for indications of urinary retention or decreased gastric motility1.
Why it happens (mechanism)
Additive effects on gastric motility
How to manage this interaction
Keep taking both medicines as prescribed unless your doctor or pharmacist tells you otherwise. The main step here is watching for warning signs.
- Watch for severe or worsening constipation, belly bloating or swelling, or not passing stool or gas.
- Watch for trouble urinating or a feeling of not fully emptying your bladder.
- Report these to your pharmacist or prescriber promptly.
Your care team may monitor you more closely and can adjust and individualize your treatment if needed. Staying hydrated and active can help keep your bowels moving.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Acetaminophen And Codeine and Pipenzolate Bromide together?
Taking codeine (with acetaminophen) alongside pipenzolate bromide can add up to cause serious constipation or urinary retention. Watch for these signs and tell your care team, who can manage it. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Acetaminophen And Codeine and Pipenzolate Bromide 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 Acetaminophen And Codeine and Pipenzolate Bromide interaction managed?
Keep taking both medicines as prescribed unless your doctor or pharmacist tells you otherwise. The main step here is watching for warning signs. Watch for severe or worsening constipation, belly bloating or swelling, or not passing stool or gas. Watch for trouble urinating or a feeling of not fully emptying your bladder. Report these to your pharmacist or prescriber promptly. Your care team may mo… 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 Pipenzolate Bromide 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 (1)
- Product Information: CARISOPRODOL, ASPIRIN, CODEINE PHOSPHATE oral tablets, carisoprodol, aspirin, codeine phosphate oral tablets. Ingenus Pharmaceuticals LLC (per DailyMed), Orlando, FL, 2021. DailyMed
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