Mixing Codeine and Opioids
- Codeine also called
- lean, purple drank, co-codamol, dihydrocodeine
- Opioids also called
- opiate, opiates, opioid, heroin, dope, smack
Dangerous
Stacking codeine onto a stronger opioid adds meaningful respiratory depression for very little extra effect — the worst possible ratio. Codeine is also frequently taken in paracetamol combination products, which quietly adds a liver ceiling to the problem.
The risk here is to the body — breathing, heart, temperature or organs. Set limits before you start, because this kind of harm does not announce itself in time to react.
Can you mix Codeine and Opioids?
High risk of death or life-changing injury. Do not combine.
- Codeine
- Weak, but metabolised unpredictably between people
- Opioids
- Full agonists — heroin, oxycodone, morphine
- Codeine Intoxication Associated with Ultrarapid CYP2D6 Metabolism. NEJM. https://www.nejm.org/doi/full/10.1056/NEJMoa041888
- Codeine Therapy and CYP2D6 Genotype. Medical Genetics Summaries, NCBI. https://www.ncbi.nlm.nih.gov/books/NBK100662/
Checking more than two?
Combinations of three or more carry risks that no pair-by-pair chart can show. The checker rates every pair at once and flags the whole-mix ones on top.
Open this in the checkerRelated combinations
All combinations →Rated dangerous. Educational information only, not medical advice. Absence of a documented interaction is not evidence of safety.