Medications and Drugs
Pharmacy Author: Omudhome Ogbru, PharmD
Medical and Pharmacy Editor: Jay W. Marks, MD
GENERIC NAME: codeine
BRAND NAMES: none
DRUG CLASS AND MECHANISM: 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.
PRESCRIPTION: Yes
GENERIC AVAILABLE: Yes
PREPARATIONS: Tablets: 15, 30, 60 mg. Solution: 15 mg/5ml (teaspoon).
Injection: 15 and 30 mg/ml.
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.
NURSING MOTHERS: Small amounts of codeine are secreted in
breast-milk,
but the risk of adverse events in the infant is small.
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suddenly withdrawn after prolonged use, symptoms of withdrawal may develop.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.
Reference: FDA Prescribing Information
Last Editorial Review: 12/10/2008
Report Problems to the Food and Drug Administration
You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.
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