Eletriptan and Acetaminophen And Codeine: Interaction Details
AI-assisted, pharmacist-reviewed · AI content regenerated Jul 11, 2026 · Source data updated Jul 1, 2026 · Sources: FDA labeling, DDInter 2.0, cited literature
Acetaminophen And Codeine
Eletriptan
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 contains codeine, an opioid, and you also take eletriptan (Relpax) for migraines. Both can gently raise a brain chemical called serotonin. When two medicines do that together, there is a small chance of a reaction called serotonin syndrome.
Signs to watch for include feeling agitated or confused, a racing heart, shakiness or muscle twitching, sweating, or fever. This is considered a possible risk based on how these drugs work, not something that happens to most people. The good news is your care team can watch for it and manage it easily. Keep taking both as prescribed, and call your pharmacist or doctor if you notice those symptoms.
Effect: Additive serotonergic activity raising the theoretical risk of serotonin syndrome when codeine (with acetaminophen) is combined with the 5-HT1 agonist eletriptan.
- Mechanism: Additive serotonergic effects; opioids such as codeine have serotonergic properties, and eletriptan is a triptan acting on serotonin receptors.
- Direction/magnitude: Additive PD effect; magnitude not quantified.
- Onset: Unspecified; risk greatest at initiation and dose escalation.
- Evidence: Theoretical, severity rated major.
- Management: Observe for autonomic instability, neuromuscular excitation, and mental status changes; discontinue codeine if serotonin syndrome is suspected.
What happens
Increased risk of serotonin syndrome
Interaction Deep Dive
Concomitant use of opioids, such as codeine, with serotonergic drugs has resulted in serotonin syndrome. If concomitant use is needed, carefully observe the patient, particularly during treatment initiation and dose adjustments. Discontinue codeine if serotonin syndrome is suspected123.
Why it happens (mechanism)
Additive serotonergic effects
How to manage this interaction
This combination can be used when needed, but your care team will keep an eye on you, especially when you first start either drug or when a dose changes.
- Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise.
- Watch for warning signs: agitation, confusion, fast heartbeat, sweating, tremor or muscle twitching, shivering, or fever.
- Get prompt help if those symptoms appear, since the codeine may be stopped if serotonin syndrome is suspected.
- Tell your pharmacist about all medicines and supplements you take, since other serotonergic drugs can add to the risk.
Management is individual — confirm any change with your pharmacist or prescriber.
Literature reports
1 report — tap to read
Common questions
Can I take Eletriptan and Acetaminophen And Codeine together?
Using codeine and eletriptan together carries a small, mostly theoretical risk of serotonin syndrome; keep taking both as prescribed and seek help quickly if you notice agitation, rapid heartbeat, sweating, shivering, or muscle twitching. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Eletriptan 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 Eletriptan and Acetaminophen And Codeine interaction managed?
This combination can be used when needed, but your care team will keep an eye on you, especially when you first start either drug or when a dose changes. Keep taking both as prescribed unless your doctor or pharmacist tells you otherwise. Watch for warning signs: agitation, confusion, fast heartbeat, sweating, tremor or muscle twitching, shivering, or fever. Get prompt help if those symptoms appea… 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 Eletriptan 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 (3)
- Product Information: Codeine sulfate oral tablets, codeine sulfate oral tablets. West-Ward Pharmaceuticals Corp (per DailyMed), Eatontown, NJ, 2016. DailyMed
- 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 Eletriptan
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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