Dabrafenib 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
Dabrafenib
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.
Dabrafenib (Tafinlar) may make your codeine work less well. Codeine is a prodrug, meaning your body has to change it into morphine to relieve pain. Dabrafenib speeds up the liver enzyme (CYP3A4) that handles codeine, which can lower how much morphine your body makes. That may mean weaker pain relief. If you have been taking codeine for a while, you could also feel early withdrawal signs like sweating, chills, a runny nose, or feeling anxious or achy.
The good news: your care team can manage this. Keep taking both as prescribed and let your doctor or pharmacist know if your pain isn't controlled or you feel off. They can adjust things safely.
Mechanism: Dabrafenib is a CYP3A4 inducer. Codeine is a prodrug: CYP2D6 converts it to morphine (active analgesic), while CYP3A4 shunts it to inactive norcodeine. Induction of CYP3A4 increases norcodeine formation and reduces the fraction available for CYP2D6 conversion, lowering morphine exposure and analgesic effect.
- Direction: reduced opioid efficacy; possible withdrawal in physically dependent patients
- Onset: unspecified
- Evidence: theoretical
- Management: monitor for reduced analgesia and withdrawal signs; codeine dose may need upward, individualized titration. If dabrafenib is stopped, anticipate rising codeine/morphine levels and monitor for sedation/respiratory depression, with possible dose reduction.
What happens
Reduced codeine and morphine exposure, reduced opioid efficacy and precipitation of opioid withdrawal
Interaction Deep Dive
Concomitant use of codeine with CYP3A4 inducers may result in reduced codeine levels, greater norcodeine levels, and less metabolism via CYP2D6 with resultant lower morphine levels, resulting in decreased efficacy or onset of a withdrawal syndrome in patients who have developed physical dependence. If concomitant use is needed, closely monitor patients for decreased efficacy or signs of opioid withdrawal syndrome, and consider increasing the dose of codeine as necessary. If a CYP3A4 inducer is being discontinued, consider codeine dose reduction and closely monitor patients for signs of respiratory depression or sedation12.
Why it happens (mechanism)
Induction of CYP3A4-mediated codeine metabolism
How to manage this interaction
Keep taking both medicines as prescribed unless your care team tells you otherwise. This interaction can usually be managed with monitoring and dose tailoring.
- Watch for weaker pain relief or withdrawal signs (sweating, chills, runny nose, muscle aches, anxiety) and report them.
- Your team may monitor you more closely and adjust your codeine dose, individualized to you, if pain isn't controlled.
- If dabrafenib is ever stopped, tell your team, since your codeine dose may need to come down to avoid excess sedation or slowed breathing.
Raise any changes with your pharmacist or prescriber before making adjustments yourself.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Dabrafenib and Acetaminophen And Codeine together?
Dabrafenib can speed up how your body processes codeine, so codeine may relieve pain less well and could trigger withdrawal if you're dependent; keep taking both as prescribed and tell your care team if pain worsens or you feel off so they can adjust and monitor. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Dabrafenib 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 Dabrafenib and Acetaminophen And Codeine interaction managed?
Keep taking both medicines as prescribed unless your care team tells you otherwise. This interaction can usually be managed with monitoring and dose tailoring. Watch for weaker pain relief or withdrawal signs (sweating, chills, runny nose, muscle aches, anxiety) and report them. Your team may monitor you more closely and adjust your codeine dose, individualized to you, if pain isn't controlled. If… 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 Dabrafenib 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 (2)
- Product Information: Codeine sulfate oral solution, codeine sulfate oral solution. Hikma Pharmaceuticals USA Inc(per FDA), Berkeley Heights, NJ, 2023. DailyMed
- Product Information: Codeine sulfate oral tablets, codeine sulfate oral tablets. Hikma Pharmaceuticals USA Inc. (per FDA), Berkeley Heights, NJ, 2023. DailyMed
Keep reading about Acetaminophen And Codeine
Keep reading about Dabrafenib
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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