epocrates logo
epocrates logo
epocrates logo
  • 0

Interaction Check

epocrates logo

Sign in to access our clinical decision support tools

Sign in Create Account

Selected Drugs Clear All

  • remove codeine/ guaifenesin
    generic
  • remove diazepam rectal
    generic
  • remove Ritalin LA
    methylphenidate

multicheck MultiCheck Results - 2 Interactions

Smiley face Smiley face

Avoid/Use Alternative

Smiley face Smiley face codeine/guaifenesin (generic) + diazepam rectal (generic)

Avoid/Use Alternative


codeine + diazepam

avoid combo if antitussive use; otherwise use alternative or monitor respiratory rate, BP; decr. dose of one or both drugs, use lowest effective doses and shortest duration of concomitant tx: combo may incr. risk of profound CNS and respiratory depression, psychomotor impairment, severe hypotension, including orthostasis, syncope; may alter seizure control (additive effects; antagonistic effects, codeine may decr. seizure threshold)

Smiley face Smiley face codeine/guaifenesin (generic) + Ritalin LA (methylphenidate)

Avoid/Use Alternative


codeine + methylphenidate

use alternative or monitor serotonin syndrome symptoms, especially during initiation/titration: combo may incr. risk of serotonin syndrome (additive effects)

Additional Considerations

Smiley face Smiley face codeine in codeine/guaifenesin

consider prescribing an opioid overdose reversal agent, especially with concomitant CNS depressant use

add MAO inhibitor to Interaction Check if recent (14 days) use

Smiley face Smiley face methylphenidate in Ritalin LA

add MAO inhibitor to Interaction Check if recent (14 days) use

avoid combo with beverages or products containing ethanol and some ER methylphenidate formulations (including capsule, chewable, oral suspension, ODT); combo may incr. methylphenidate release rate, levels, risk of adverse effects, decr. duration of efficacy

Help
FDA Reporting Form
 
Download Epocrates from the App Store Download Epocrates from the Play Store
About Us Features Business Solutions Help & Feedback Cookie Preferences
© 2026 epocrates, Inc.    Terms of Use Privacy Policy Editorial Policy Do Not Sell or Share My Information