Clidinium and Acetaminophen And Codeine: 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
Clidinium
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 here contains codeine, which can slow down your gut and make you constipated. Clidinium is a medicine that also relaxes and slows the gut. When you take both, those effects can add up.
The main worry is that your bowels could slow down too much, leading to severe constipation or trouble emptying your bladder (urinary retention). In rare cases, a very slow gut can stop moving altogether, which needs medical care. This concern is based more on how these drugs work than on lots of real-world reports, so try not to worry. Your care team can watch for these signs and help you manage them.
Effect: Additive slowing of GI motility, increasing risk of severe constipation, urinary retention, and potentially paralytic ileus.
Mechanism: Codeine (an opioid) reduces GI motility; clidinium is an anticholinergic that further inhibits smooth muscle motility and bladder emptying. Effects are pharmacodynamically additive.
- Direction: Both agents compound bowel/bladder hypomotility.
- Onset: Unspecified.
- Evidence: Theoretical; severity rated major.
- Management: Monitor for reduced gastric motility, abdominal distension, and urinary retention. Consider bowel regimen; individualize dosing.
What happens
An increased risk of paralytic ileus
Interaction Deep Dive
Concomitant use of codeine with anticholinergic drugs may increase the risk of urinary retention and/or severe constipation, which may lead to paralytic ileus. Monitor patients for signs of urinary retention or reduced gastric motility when codeine is used concomitantly with anticholinergic drugs1.
Why it happens (mechanism)
Additive effects on gastric motility
How to manage this interaction
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. The goal is simply to stay ahead of the gut and bladder slowing that both drugs can cause.
- Watch for constipation, bloating, belly pain, no bowel movements, or trouble urinating, and report these promptly.
- Stay well hydrated and stay as active as you comfortably can.
- Your care team may monitor you more closely and can adjust doses to fit your needs, or suggest a bowel regimen.
- Ask your pharmacist before adding any over-the-counter product for constipation.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Clidinium and Acetaminophen And Codeine together?
Taking codeine with clidinium can add up to cause serious constipation or urinary retention, so watch for those signs and tell your care team if they happen. This risk is theoretical but rated major, and your team can manage it with monitoring. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Clidinium 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 Clidinium and Acetaminophen And Codeine interaction managed?
Keep taking both medicines as prescribed unless your prescriber tells you otherwise. The goal is simply to stay ahead of the gut and bladder slowing that both drugs can cause. Watch for constipation, bloating, belly pain, no bowel movements, or trouble urinating, and report these promptly. Stay well hydrated and stay as active as you comfortably can. Your care team may monitor you more closely and… 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 Clidinium 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 (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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