Codeine is a narcotic analgesic (pain reliever) derived from opium. It is used alone and in
combination products to treat mild to moderate pain and as a cough suppressant.
Interactions with Vitamins, Herbs, and Foods
In some cases, an herb or supplement may appear in more than one category, which may seem
contradictory. For clarification, read the full article for details about the summarized
Avoid: Reduced drug absorption/bioavailability—Avoid these supplements
when taking this medication since the supplement may decrease the absorption and/or activity
of the medication in the body.
Tannin-containing herbs* such as green tea, black tea, uva ursi,
black walnut, red raspberry, oak, and witch hazel
|Depletion or interference
|Side effect reduction/prevention
An asterisk (*) next to an item in the summary indicates that the
interaction is supported only by weak, fragmentary, and/or contradictory scientific
Interactions with Herbs
Tannins are a group of unrelated chemicals that give plants an astringent taste. Herbs with
large amounts of tannins may interfere with the absorption of codeine and should not be taken
together with codeine or codeine-containing products.1 Herbs containing high levels
of tannins include green tea (Camellia
sinensis), black tea, uva ursi
(Arctostaphylos uva-ursi), black walnut (Juglans nigra),red raspberry (Rubus idaeus),oak (Quercus spp.), and witch hazel (Hamamelis virginiana).
Interactions with Foods and Other Compounds
Codeine commonly causes gastrointestinal (GI) upset. Codeine and codeine-containing products
may be taken with food to reduce or prevent GI upset.2 A common side effect of
narcotic analgesics, including codeine, is
constipation. Increasing dietary fiber
(fruits, vegetables, beans, whole-grain foods, and others) and water intake can ease
Alcohol causes a loss of coordination, impaired judgment, decreased alertness, drowsiness, and
other actions. Narcotic analgesics, including codeine, cause similar loss of control.
Combining codeine and alcohol increases the risk of accidental injury. People taking
codeine-containing products should avoid alcohol.
1. Brinker F. Interactions of pharmaceutical and botanical medicines.
J Naturopathic Med 1997;7(2):14–20.
2. Threlkeld DS, ed. Central Nervous System Drugs, Narcotic Agonist
Analgesics. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and
Comparisons, Feb 1990, 243d.