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Codeine is a weak narcotic pain-reliever and cough suppressant similar to morphine and hydrocodone. In fact, a small amount of codeine is converted to morphine in the body. The precise mechanism of action of codeine is not known; however, like morphine, codeine binds to receptors in the brain (opioid receptors) that are important for transmitting the sensation of pain throughout the body and brain. Codeine increases tolerance to pain, decreasing discomfort, but the pain still is apparent to the patient. In addition to reducing pain, codeine also causes sedation drowsiness and depresses breathing. Codeine frequently is combined with acetaminophen (Tylenol) or aspirin for more effective pain relief.

STORAGE

Codeine should be stored between 15 to 30 C (59 to 86 F).

PRESCRIBED FOR: Codeine is used for the relief of mild to moderately severe pain and for suppressing cough.

DOSING: The usual adult dose of codeine is 15-60 mg every 4-6 hours.

DRUG INTERACTIONS: Codeine can impair thinking and physical abilities required for driving or operating machinery. Alcohol and other sedatives such as alprazolam (Xanax) can produce further brain impairment and even confusion when combined with codeine. Therefore, alcohol and other sedatives should be limited when taking codeine.

PREGNANCY: Safety during pregnancy has not been established. Codeine is generally avoided in pregnancy because it may cause fetal physical dependence, withdrawal and growth retardation.

SIDE EFFECTS

The most frequent side effects of codeine include lightheadedness, dizziness, nausea, vomiting, shortness of breath, and sedation. Other side effects include allergic reactions, constipation, abdominal pain, rash and itching. Codeine is habit forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief. If codeine is suddenly withdrawn after prolonged use, symptoms of withdrawal may develop. The dose of codeine should be reduced gradually in order to avoid withdrawal symptoms.

Codeine overdose

Codeine is an opioid pain reliever that is sometimes used to treat mild to moderate pain. (Like morphine, it’s an opiate). It can be found in certain cough syrups or certain prescription pills like Robitussin-A-C and Triacin-C. Short-term use of codeine may be safe, but long-term use of the drug has potential side effects. In fact, some people who have taken codeine for extended periods of time have become physically dependent on it and have withdrawal symptoms when they stop taking it. If you’re considering taking codeine for pain relief or as a cough suppressant for your child, talk with your doctor about its potential benefits and risks first.

It important to know that Codeine overdose occurs when someone takes more than the normal or recommended amount of this medicine. This can be by accident or on purpose.

In response to a study by the Icahn School of Medicine at Mount Sinai, codeine (a pain reliever) can cause overdose symptoms in a person who has taken too much. According to their findings, overdosing on codeine may cause:

• Bluish lips and fingernails
•  Severe muscle weakness
• Cold and clammy skin
• Breathlessness or very shallow breathing
• Unconsciousness
• Extreme drowsiness
• Weakness or fatigue
• Small or pinpoint pupils
• Coma
• Weak pulse or low blood pressure
•  Itching
• Pain in the stomach or intestines
• Slow heartbeat
• Slurring words
• Nausea

Where Found

The effects of an overdose with this product can be life threatening. If you or someone you are with overdoses on Codeine, call your local emergency number (such as 911) or the national toll-free Poison Help hotline (1-800-222-1222) from anywhere in the United States.

Warnings

Codeine is prescribed to treat mild to moderate pain, including pain after surgery and wounds. Codeine may also be used to help control coughing. You should not use codeine without talking to your doctor if you have asthma or other breathing problems; liver disease; a history of morphine addiction; head injury or brain tumor; bleeding disorders such as hemophilia; bowel obstruction or blockage; alcoholism ; adrenal gland tumor (pheochromocytoma); stomach/intestinal ulcers (including partial digestion); kidney disease.

FAQ’s

Why is this medication prescribed?

Codeine belongs to a class of medications called opiate (narcotic) analgesics and to a class of medications called antitussives. When codeine is used to treat pain, it works by changing the way the brain and nervous system respond to pain. When codeine is used to reduce coughing, it works by decreasing the activity in the part of the brain that causes coughing.

Codeine is also available in combination with aspirin, carisoprodol, acetaminophen, and promethazine. This monograph only includes information about the use of codeine. If you are taking a codeine combination product, be sure to read information about all the ingredients in the product you are taking and ask your doctor or pharmacist for more information.

What should I do if I forget a dose?

Codeine can be taken as needed, or you may be prescribed a higher dose if it has been found to help with pain relief. Take the missed dose as soon as possible; however, if it is almost time for the next dose, skip the missed dose and take the next regularly scheduled dose. Do not take a double dose of codeine to make up for a missed one.