Drug & supplement interaction

Onion + Codeine, Paracetamol

Codeine, Paracetamol brand name: Co-codamol.

Moderate Interaction
Medically reviewed by · Updated September 2026
The bottom line Moderate

Onion has a moderate interaction with Codeine, Paracetamol. Theoretically, taking onion might increase the levels and clinical effects of drugs metabolized by CYP2E1.

Read the full interaction report
SeverityModerate
LikelihoodPossible
EvidenceB
What do Severity, Likelihood & Evidence mean?
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Interaction report

Onion and Codeine, Paracetamol

Here is the interaction we found between these two, with the evidence behind it.

Moderate

CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES

Why this applies to Codeine, Paracetamol

Codeine, Paracetamol falls under CYTOCHROME P450 2E1 (CYP2E1) SUBSTRATES — the group Onion interacts with.

Theoretically, taking onion might increase the levels and clinical effects of drugs metabolized by CYP2E1.
Animal research shows that taking onion powder inhibits CYP2E1. However, this interaction has not been reported in humans.
Severity Moderate Likelihood Possible Evidence B

Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.

Dr. Brian Staiger, PharmD, BCPS
Dr. Brian Staiger explains PharmD, Clinical Pharmacist

Here's the situation with Co-codamol (codeine plus paracetamol/acetaminophen) and onion. The interaction on file says onion may block an enzyme called CYP2E1. That enzyme matters mostly for paracetamol, where it helps create a small amount of a toxic byproduct. In theory, slowing CYP2E1 might actually shift how paracetamol is handled, but honestly this effect is tiny and only seen in animal studies, never confirmed in people.

Worth knowing: codeine itself is activated by a different enzyme (CYP2D6), so onion isn't really part of that side of things. Bottom line, eating onion in normal food amounts is very unlikely to cause any problem with Co-codamol. If you're thinking about concentrated onion supplements, just run it by your pharmacist or doctor first.

Contact Dr. Brian directly if you have additional questions on this interaction
References
  1. Teyssier, C., Amiot, M. J., Mondy, N., Auger, J., Kahane, R., and Siess, M. H. Effect of onion consumption by rats on hepatic drug-metabolizing enzymes. Food Chem.Toxicol. 2001;39(10):981-987. PubMed

What These Ratings Mean

Every interaction above is graded three ways — here’s the key to each label.

Severity how clinically significant the interaction is
Major

Clinically significant. Avoid the combination, or use only under close professional supervision.

Moderate

Usually worth avoiding or managing — may need monitoring, a dose change, or timing apart.

Minor

Generally not serious. Be aware of it and mention it to your pharmacist.

Likelihood how strong the evidence is that the interaction actually happens in people
  • LikelyWell-controlled human studies have demonstrated the likely existence of this interaction.
  • ProbableInteraction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
  • PossibleInteraction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists.
  • UnlikelyInteraction has been demonstrated in animal or in lab research but has been shown not to occur in humans.
Evidence the quality of the studies behind the rating (graded A–D)
  • AHigh-quality meta-analysis (quantitative systematic review).
  • BCase-control study.
  • CConsensus.
  • DAnecdotal evidence.

These ratings are for information only. Never start, stop, or otherwise change your therapy before speaking with your provider.

Keep it in perspective

Onion Also Interacts With Other Medications

Onion has 274 moderate known drug interactions in our database — the Codeine, Paracetamol one above is one of them. If you take anything else, check it against the full list below.

Moderate 274 No known interaction 2,556 (incl. Codeine, Paracetamol)
Taking anything else?

Check Another of Your Medications Against Onion

Covers the 2,830 medications we’ve checked against Onion. Pick one to open its full report.

Everything else you take

See Every Supplement That Interacts With Codeine, Paracetamol

This page covers Onion only. If you take other supplements — a multivitamin, a sleep aid, something for joints — the Codeine, Paracetamol page lists 240 supplements it has a documented interaction with, worst first, each one explained.

The most serious there right now: 1,4-butanediol (major), Activated Charcoal (major), Asarabacca (major), Beer (major) and Gamma-hydroxybutyrate (ghb) (major).

By severity: 9 major · 191 moderate · 40 minor.

From our pharmacist’s overview on the Codeine, Paracetamol page

“Co-codamol pairs codeine, an opioid that slows breathing, with paracetamol, which can strain the liver, so I read its supplement list warily. Nine of the 240 ingredients on file carry a major rating, and most of those pile extra sedation onto the codeine.”

Reviewed by 2 · Jul 18, 2026

Open the Codeine, Paracetamol interaction page

One more smart check

Taking Onion as Part of a Dietary Supplement Product? Check It for Interactions

We hold 1,061 real supplement products containing Onion, each one broken down to its full ingredient list — and combination products often carry several ingredients besides Onion. Your product may carry other ingredients that interact with Codeine, Paracetamol too, on top of Onion — and those would not show on this page. Find your product and we’ll check every ingredient on its label:

How much people look this up

Where Onion and Codeine, Paracetamol Sit Against Everything Else

Out of every supplement and medication people look up on HelloPharmacist, here is where these two land this week — and which way each has been moving.

Supplement Onion
Top 25%

#248 of 1,452 supplements looked up here in the last 7 days

29 days ago today
Medication Codeine, Paracetamol
Top half

#1,022 of 2,830 medications looked up here in the last 7 days

29 days ago today

Position among everything looked up on this site, not a measure of how commonly either one is used or how important it is. A supplement can climb this list because of a news story. It counts every request to the page, automated ones included, and nothing here identifies anyone.

Supplement

About Onion

What is Onion?

Onion
  • Colds and respiratory symptoms
  • Heart and cholesterol health
  • Blood sugar support
  • Antimicrobial and wound care
  • Scar appearance (topical gels)

Onion is a common food with a long history in traditional medicine, and it contains antioxidants like quercetin and sulfur compounds. Eating onion as part of a balanced diet is safe for most people, but high-dose supplements have only limited human evidence for any specific health condition. Talk with your pharmacist or doctor before using concentrated onion products for a medical reason.

Read the full Onion monograph & all interactions
Keep checking

Other Drugs & Onion

Browse every other medication we’ve checked against Onion — both the ones with a known interaction and the ones without. Select any drug for the full detail.

0Major
274Moderate
0Minor
2,555No known interaction
274 Moderate 2,555 No interaction
Moderate

274 interactions

Showing 60 of 274 moderate interactions — see all 274 on the Onion page.

No interaction 2,555 drugs checked — show the list

We also checked Onion against these medications and found no known interaction in our sources. Open any page to confirm.

Showing the 60 most looked-up of 2,555 medications checked with no known interaction — see the full Onion list.

See the full Onion interactions page
See every supplement checked against Codeine, Paracetamol, ranked by severity
Sources

Sources & How We Checked

Interaction details are evidence-graded and sourced from the Natural Medicines database. The medication overview comes from MedlinePlus.

Content is written and reviewed by licensed HelloPharmacist pharmacists. See our data sources and editorial standards for how this information is built and checked.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

© 2021 Therapeutic Research Center, LLC

Keep exploring
Onion monograph › Uses, safety, and every drug interaction in one place Codeine, Paracetamol supplement interactions › Every supplement checked against Codeine, Paracetamol, ranked by severity Supplement interaction checker › Check any supplement or product against your medications Browse medications A–Z › Every drug we've checked against herbs & supplements Ask a pharmacist › Free, personal answer from our licensed team
Pharmacist Counseling Corner

Taking Onion and Codeine, Paracetamol Together: Common Questions

Can you take Onion with Codeine, Paracetamol?
There is a moderate interaction, so it may be acceptable with monitoring or timing changes — but check with your pharmacist first. Read the full details on this page and confirm with your pharmacist before combining them.
How serious is the Onion and Codeine, Paracetamol interaction?
We rate it Moderate. This combination may require monitoring, a dose adjustment, or separating the times you take each one. Consult your pharmacist before using them together.

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Still Have a Question About Codeine, Paracetamol and Onion?

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This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.