Sevoflurane 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
Sevoflurane
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, which is an opioid. Sevoflurane is a gas used to keep you asleep during surgery. Both can slow down your breathing, and when they are used together that effect can add up. Opioids like codeine can also make the anesthesia gas work a bit stronger, so less of it may be needed.
This is a well-known combination in surgery, and your anesthesia team handles it every day. They will watch your breathing closely and help you breathe if needed. Just make sure your surgical team knows you take codeine so they can plan for it.
Effect: Opioids (codeine) may lower the MAC of sevoflurane and can augment sevoflurane-induced respiratory depression (additive PD effect on the CNS respiratory drive).
- Direction: Increased anesthetic potency (less sevoflurane needed) plus increased risk of respiratory depression.
- Evidence: Theoretical; mechanism not fully characterized, extrapolated from other inhalational agents.
- Onset: Unspecified (intraoperative/perioperative).
- Management: Compatible as commonly used in surgical practice. Monitor respiration, titrate sevoflurane accordingly, and assist ventilation if required.
What happens
Reduced sevoflurane (MAC) exposure needed to produce anesthesia and an increased risk of respiratory depression
Interaction Deep Dive
When sevoflurane is given together with opioids, the minimum alveolar concentration (MAC) of sevoflurane may be lowered, comparable to what occurs with other inhalational anesthetics. Because sevoflurane can produce respiratory depression, this effect may be intensified by opioids. Nevertheless, opioids at doses typically employed in surgical settings can be used alongside sevoflurane. Respiration should be monitored, with ventilatory support provided when required1.
Why it happens (mechanism)
Unknown
How to manage this interaction
This combination is used routinely and safely in surgery, so there is no need to stop either medicine on your own.
- Tell your surgical and anesthesia team you take acetaminophen with codeine so they can plan.
- Your anesthesia dose may be adjusted and individualized by your care team, since opioids can reduce the amount of sevoflurane needed.
- Your team will monitor your breathing closely and assist your ventilation if necessary.
If you have questions before a procedure, raise them with your pharmacist or prescriber.
Management is individual — confirm any change with your pharmacist or prescriber.
Common questions
Can I take Sevoflurane and Acetaminophen And Codeine together?
Codeine and sevoflurane both slow breathing and are commonly used together in surgery; your anesthesia team manages this by adjusting the anesthetic and closely watching your breathing. Always confirm with your pharmacist or prescriber before making any change.
How serious is the Sevoflurane and Acetaminophen And Codeine interaction?
It is rated moderate. Can be significant — usually manageable with monitoring.
How quickly could this interaction happen?
The documented onset is "unspecified". The timing of this interaction is not well characterized.
How is the Sevoflurane and Acetaminophen And Codeine interaction managed?
This combination is used routinely and safely in surgery, so there is no need to stop either medicine on your own. Tell your surgical and anesthesia team you take acetaminophen with codeine so they can plan. Your anesthesia dose may be adjusted and individualized by your care team, since opioids can reduce the amount of sevoflurane needed. Your team will monitor your breathing closely and assist y… 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 Sevoflurane 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 anything you'd monitor while I'm on both?
References (1)
- Product Information: ULTANE(R) inhalation liquid, sevoflurane inhalation liquid. AbbVie Inc (per FDA), North Chicago, IL, 2022. DailyMed
Keep reading about Acetaminophen And Codeine
Keep reading about Sevoflurane
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.
Check another combination
Our instant two-drug interaction checker is almost here.
Still have questions about this combination?
Every question gets a real answer from a licensed pharmacist — free, and usually within a day.
Ask the pharmacist