Drug Interaction Report

Dihydrocodeine and Cyclosporine Ophthalmic: Interaction Details

Name: Dihydrocodeine and Cyclosporine Ophthalmic Interaction
Creator: Dr. Brian Staiger, PharmD, BCPS

A pharmacist-reviewed analysis of the Dihydrocodeine and Cyclosporine Ophthalmic interaction: the documented clinical effects, severity rating, onset, mechanism, and management considerations, with cited references throughout.

AI-assisted, pharmacist-reviewed · Source data updated Aug 8, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature

Dihydrocodeine

No brand names on record

Cyclosporine Ophthalmic

Cequa Cequa® Restasis® Vevye

Medically reviewed by

Dr. Brian Staiger, PharmD, BCPS

Updated Aug 8, 2026

Editorial policy · Data sources

Interaction severity

Major

Potentially serious — often needs a change or close monitoring.

Minor

Moderate

Major

Contraindicated

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 54 documented Dihydrocodeine interactions, 51 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.

Onset

unspecified

Evidence

theoretical

Severity

Major

What happens

Increased dihydrocodeine exposure and an increased risk of respiratory depression

Interaction Deep Dive

Concomitant use of dihydrocodeine with a CYP3A4 inhibitor may increase plasma concentrations of the parent drug (codeine) and the active metabolite (morphine), and may lead to prolonged opioid effects, including respiratory depression. If coadministration is necessary, consider reducing dihydrocodeine dosage and monitor for sedation and respiratory depression frequently. When discontinuing a concurrent CYP3A4 inhibitor, consider increasing dihydrocodeine dosage and monitor for signs of opioid withdrawal¹².

Why it happens (mechanism)

Inhibition of CYP3A4-mediated dihydrocodeine metabolism

Common questions

Can I take Dihydrocodeine and Cyclosporine Ophthalmic together?

Increased dihydrocodeine exposure and an increased risk of respiratory depression Always confirm with your pharmacist or prescriber before making any change.

How serious is the Dihydrocodeine and Cyclosporine Ophthalmic 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 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 Dihydrocodeine or Cyclosporine Ophthalmic 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: TREZIX(TM) oral capsules, acetaminophen caffeine dihydrocodeine bitartrate oral capsules. WraSer Pharmaceuticals (per DailyMed), Ridgeland, MS, 2016. DailyMed
Product Information: SYNALGOS(R)-DC oral capsules, aspirin, caffeine, dihydrocodeine bitartrate oral capsules. Sun Pharmaceuticals Industries Inc (per FDA), Cranbury, NJ, 2023. DailyMed

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Dihydrocodeine

Keep reading about Dihydrocodeine

All Dihydrocodeine interactions (54)

Also serious with: Linezolid Injection Clopidogrel Palonosetron Injection Dexamethasone Ophthalmic

Cyclosporine Ophthalmic

Keep reading about Cyclosporine Ophthalmic

All Cyclosporine Ophthalmic interactions (545) Cyclosporine Ophthalmic drug information

Also serious with: Dronedarone Elagolix Ensitrelvir Ezetimibe

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HelloPharmacist doesn't license one of the big commercial interaction databases, so what you'll find here is not a complete list of every known drug interaction. Instead, each entry is researched, analyzed, and written up individually — documented from the published literature, reviewed by a pharmacist, and cited so you can check every source yourself.

If a combination isn't listed here, it means we haven't documented it yet — never that it's safe. For screening a full medication list, we recommend pairing this site with a comprehensive tool like the Drugs.com Interaction Checker and, most importantly, a review by your own pharmacist. For a deep, plain-English, fully sourced explanation of a specific documented interaction — that's exactly what we built this for.

This information is for education, not a substitute for professional medical advice. Do not start, stop, or change any medication without talking to your pharmacist or prescriber.