Acetaminophen And Codeine and Tedizolid Phosphate: 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
Tedizolid Phosphate
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.
You've been prescribed tedizolid (Sivextro), an antibiotic, along with your acetaminophen and codeine pain medicine. Both can raise serotonin levels in your body. When they're combined, there's a chance those effects add up and lead to a rare but serious problem called serotonin syndrome.
Signs to watch for include feeling agitated or shaky, sweating a lot, a racing or overheated feeling, muscle stiffness, or twitching. Right now this is mostly a theoretical concern, so please don't panic. Keep taking both as prescribed unless your doctor tells you otherwise, and reach out to your pharmacist or doctor right away if any of those symptoms show up.
Effect: Additive serotonergic activity increasing the theoretical risk of serotonin syndrome.
Mechanism: Tedizolid is an oxazolidinone with weak, reversible MAO-inhibitory activity; codeine has serotonergic properties. Combined, serotonergic tone may increase (pharmacodynamic, not a PK/prodrug-activation issue).
- Direction/magnitude: Additive PD effect; magnitude not quantified.
- Onset: Unspecified.
- Evidence: Theoretical, supported by postmarketing case reports.
- Management: Monitor for hyperthermia, diaphoresis, agitation, hyperreflexia, clonus, tremor, rigidity. If symptoms emerge, discontinue tedizolid and/or the serotonergic agent as clinically appropriate and provide supportive care.
What happens
An increased risk of serotonin syndrome
Interaction Deep Dive
Serotonin syndrome has been documented in postmarketing reports involving patients receiving tedizolid alongside serotonergic agents. For this reason, patients should be watched for the development of serotonin syndrome whenever these drugs are given together. Should signs or symptoms of serotonin syndrome appear, discontinuation of tedizolid and/or the accompanying serotonergic agents may be considered as clinically appropriate, along with the start of supportive care. Patients should be advised of the heightened risk of serotonin syndrome associated with concurrent use of tedizolid and serotonergic agents. The symptoms that may accompany serotonin syndrome include hyperthermia, diaphoresis, agitation, hyperreflexia, clonus, pyrexia, opsoclonus, muscle rigidity, tremor, and hypertonia1.
Why it happens (mechanism)
Additive serotonergic effects
How to manage this interaction
Your care team can manage this safely, usually by watching you a little more closely while you take both medicines.
- Keep taking both as prescribed unless your prescriber advises a change.
- Learn the warning signs: sweating, agitation, fast heartbeat, high temperature, muscle stiffness, tremor, or twitching.
- Contact your pharmacist or doctor promptly if any of these appear. If symptoms are severe, seek urgent care.
- Tell your team about all other serotonergic medicines (antidepressants, migraine drugs, other opioids) you take.
If needed, your doctor may adjust or pause one of the medicines and provide supportive treatment.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
a) During post marketing surveillance, cases of serotonin syndrome have been documented in patients who were receiving tedizolid together with serotonergic agents 1.
Common questions
Can I take Acetaminophen And Codeine and Tedizolid Phosphate together?
Combining tedizolid with acetaminophen and codeine carries a theoretical risk of serotonin syndrome; keep taking both as prescribed but watch for sweating, agitation, high fever, muscle stiffness, or tremor and contact your care team if these occur. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Acetaminophen And Codeine and Tedizolid Phosphate 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 Tedizolid Phosphate interaction managed?
Your care team can manage this safely, usually by watching you a little more closely while you take both medicines. Keep taking both as prescribed unless your prescriber advises a change. Learn the warning signs: sweating, agitation, fast heartbeat, high temperature, muscle stiffness, tremor, or twitching. Contact your pharmacist or doctor promptly if any of these appear. If symptoms are severe, s… 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 Tedizolid Phosphate 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: SIVEXTRO® intravenous injection, oral tablets, tedizolid phosphate intravenous injection, oral tablets. Merck Sharp & Dohme Corp (per FDA), Rahway, NJ, 2026. DailyMed
Keep reading about Acetaminophen And Codeine
Keep reading about Tedizolid Phosphate
These medications also interact with supplements
Prescription drugs aren't the whole picture — herbal and dietary supplements can interact with them too. From the evidence-graded Natural Medicines database:
major · moderate · minor — check everything you take with our drug–supplement interaction checker.
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