Drug Interaction Report

Acetaminophen And Codeine and Ropeginterferon Alfa-2B-Njft: 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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Ropeginterferon Alfa-2B-Njft

Besremi
Dr. Brian Staiger, PharmD, BCPS
Medically reviewed by
Updated Jun 30, 2026
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Interaction severity
Major
Potentially serious — often needs a change or close 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, 444 are rated major — including this one.
Worried about symptoms right now? Contact your pharmacist or prescriber, or call Poison Control at 1-800-222-1222 (US). Call 911 for an emergency.
At a glance + Theoretical Effects may be stronger Prodrug involved
The Bottom Line
Combining codeine with Besremi can add up to more drowsiness and nervous-system effects, so this pairing is best avoided when possible; if you take both, stay in close contact with your care team and report unusual sleepiness or mood changes.

Here's what's going on. Your acetaminophen with codeine contains codeine, an opioid pain reliever that can make you feel drowsy or foggy. Besremi (ropeginterferon) is a long-acting interferon that can also cause mood and nervous-system side effects like tiredness, low mood, or trouble thinking clearly.

When you take both, those effects can add up, so you may feel more sedated or mentally slowed than you would from either one alone. This concern is based on how the drugs work rather than lots of real-world reports. The good news is your care team can manage this by watching you more closely and adjusting things if needed. Let them know if you feel unusually sleepy or 'off.'

Effect: Additive CNS depression / neuropsychiatric adverse events. Codeine (an opioid; note it is a CYP2D6-activated prodrug, but that is not central here) contributes sedation, while ropeginterferon alfa-2b-njft carries known neuropsychiatric toxicity (fatigue, depression, cognitive impairment).

  • Mechanism: Pharmacodynamic additive CNS effects, not a PK/enzyme interaction.
  • Direction: Increased sedation/CNS toxicity.
  • Onset: Unspecified.
  • Evidence: Theoretical; labeled as major.
  • Management: Avoid combination if possible. If required, monitor for excessive CNS toxicity, sedation, respiratory depression, and mood changes; dose may need individualization.
Onset
unspecified
Evidence
theoretical
Severity
Major

What happens

Increased risk of sedation

Interaction Deep Dive

Taking ropeginterferon alfa-2b-njft together with narcotics, hypnotics, or sedatives can lead to additive neuropsychiatric effects, so this combination should be avoided. Should concurrent administration be required, watch for excessive CNS toxicity1.

Why it happens (mechanism)

Additive neuropsychiatric adverse events

How to manage this interaction

What your care team may do:

  • Where possible, avoid using these two together, or consider an alternative pain option.
  • If you do need both, expect closer monitoring for excessive drowsiness, confusion, slowed breathing, or mood changes.
  • Doses may be adjusted and individualized by your care team.

What you should do: Keep taking both as prescribed unless your prescriber tells you otherwise. Tell your pharmacist or doctor if you feel unusually sleepy, dizzy, low in mood, or find it hard to think clearly, and avoid driving until you know how the combination affects you.

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

Common questions

Can I take Acetaminophen And Codeine and Ropeginterferon Alfa-2B-Njft together?

Combining codeine with Besremi can add up to more drowsiness and nervous-system effects, so this pairing is best avoided when possible; if you take both, stay in close contact with your care team and report unusual sleepiness or mood changes. Always confirm with your pharmacist or prescriber before making any change.

How serious is the Acetaminophen And Codeine and Ropeginterferon Alfa-2B-Njft 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 Ropeginterferon Alfa-2B-Njft interaction managed?

What your care team may do: Where possible, avoid using these two together, or consider an alternative pain option. If you do need both, expect closer monitoring for excessive drowsiness, confusion, slowed breathing, or mood changes. Doses may be adjusted and individualized by your care team. What you should do: Keep taking both as prescribed unless your prescriber tells you otherwise. Tell your p… 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 Ropeginterferon Alfa-2B-Njft 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)

  1. Product Information: BESREMi(R) subcutaneous injection, ropeginterferon alfa-2b-njft subcutaneous injection. PharmaEssentia Corporation (per FDA), Burlington, MA, 2021. DailyMed
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Beyond drug–drug

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