- Surprising Reasons You're in Pain Slideshow
- Take the Pain Quiz
- Joint-Friendly Exercises to Reduce RA Pain Slideshow
- What is codeine? How does it work (mechanism of action)?
- What are the uses for codeine?
- What are the side effects of codeine?
- Is codeine addictive? Is it a controlled substance?
- Can I drink alcohol with codeine? What other drugs interact with codeine?
- What is the dosage for codeine? How is it taken?
- Is it safe to take codeine if I am pregnant or breastfeeding?
- What else should I know about codeine?
What is codeine? How does it work (mechanism of action)?
Codeine is a narcotic pain-reliever and cough suppressant similar to morphine and hydrocodone. Moreover, 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. The FDA approved codeine in 1950.
What are the side effects of codeine?
The most frequent side effects of codeine include:
- Shortness of breath
- Allergic reactions
- Abdominal pain
Serious side effects of codeine include:
- Life-threatening respiratory depression
- Severe low blood pressure
- Adrenal insufficiency
- Accidental ingestion of codeine can result in fatal overdose
Is codeine addictive? Is it a controlled substance?
Codeine is habit forming (addictive). Mental and physical dependence can occur but are unlikely when used for short-term pain relief. Using codeine during pregnancy can cause opioid withdrawal syndrome in the newborn, which may be life-threatening if not treated.
If codeine is suddenly withdrawn after prolonged use, symptoms of withdrawal may develop.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.
Can I drink alcohol with codeine? What other drugs interact with codeine?
- 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 not be used when taking codeine.
- Drugs that stimulate and also block opioid receptors (for example, pentazocine) reduce the effect of codeine. Such drugs should not be combined with codeine.
- Drugs that block the action of acetylcholine (anticholinergic drugs) increase the occurrence of urinary retention and constipation when combined with codeine.
- Monoamine oxidase inhibitors (MAOIs) class of antidepressants (for example, isocarboxazid [Marplan], phenelzine [Nardil], tranylcypromine [Parnate], selegiline [Eldepryl], and procarbazine [Matulane]) significantly increase the action of codeine. Codeine should not be used in patients taking MAOIs or within 14 days of stopping MAOIs.
What is the dosage for codeine? How is it taken?
- The usual adult dose of codeine for pain is 15-60 mg every 4-6 hours as needed.
- The dose for cough is 10 to 20 mg every 4-6 hours as needed.
- The maximum dose for treating cough is 120 mg every 24 hours.
Is it safe to take codeine if I am pregnant or breastfeeding?
Small amounts of codeine are secreted in breast milk, but the risk of adverse events in the infant is small.
What else should I know about codeine?
Codeine is available as:
- Tablets: 15, 30, 60 mg.
- Solution: 15 mg/5ml (teaspoon).
- Injection: 15 and 30 mg/ml.
Codeine should be stored between 15 C to 30 C (59 F to 86 F).
You need a prescription from your doctor to obtain codeine.
Pain Management Resources
Codeine is a narcotic pain reliever (analgesic) used to treat mild to moderately severe pain. It is frequently combined with Tylenol or aspirin for more effective pain relief. Common side effects include itching, rash, stomach pain, constipation, shortness of breath, nausea, lightheadedness, and dizziness.
More serious adverse effects codeine are severe low blood pressure, adrenal insufficiency,
Codeine is a controlled narcotic and it has potential for abuse. People with current or previous drug addiction problems should be monitored closely for addiction. Dependence and addiction can occur with codeine, even at prescribed dosages when taken over long periods. Misuse of codeine can lead to serious cardiac events and sudden death.
It is important to be aware of drug interactions, effects on pregnancy and nursing mothers, as well as common side effects on the user.
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Treatment & Diagnosis
- Headaches FAQs
- Back Pain FAQs
- Pain FAQs
- Medication Disposal
- Dangers of Mixing Medications
- How To Reduce Your Medication Costs
- Pharmacy Visit, How To Get The Most Out of Your Visit
- Indications for Drugs: Approved vs. Non-approved
- Pain (Acute and Chronic)
- Drugs: Buying Prescription Drugs Online Safely
- Prescription Drug Abuse
- Drugs: The Most Common Medication Errors
- Generic Drugs, Are They as Good as Brand-Names?
Medications & Supplements
- hydrocodone/acetaminophen, Vicodin, Vicodin ES, Vicodin HP, Anexsia, Lortab, Lorcet, Lorcet Plus, No
- fentanyl patch (Duragesic)
- montelukast, Singulair
- Drugs: Questions to Ask Your Doctor or Pharmacist about Your Drugs
- Drug Interactions
- Narcotic Pain Medications (Opioids, Analgesics, Narcotics)
- Dilaudid vs. Oxycodone
- Oxycodone vs. Codeine
Prevention & Wellness
- Doctors Curbing First-Time Prescriptions for Opioids
- ER Docs Prescribe More Opioids Than They Realize
- Opioid ODs Have Cut Into U.S. Life Expectancy: CDC
- Addicts Try to Avoid Deadly Fentanyl, But Many Tragically Fail
- Opioid-Related Deaths Might Be Underestimated: CDC
- Rehab Services Lacking in States Hit Hard by Opioids
- Drug OD Deaths Have Nearly Tripled Since 1999: CDC
- Kids' OD Risk Rises When Opioids Left Out at Home
- Some Docs May Help Fuel Opioid Abuse Epidemic
- What You Need to Know When Prescribed an Opioid Painkiller
- What Is Kratom? Why Does the DEA Want to Ban It?
- Codeine Not Safe for Kids, Pediatricians Warn
- Does Medical Marijuana Reduce Need for Other Meds?
- Programs to Spot Painkiller Abuse Work, But Are Underused
- Painkillers Don't Ease Disability Due to Nerve Damage: Study
- Opioids: What Patients -- and Doctors -- Think
- Primary Care Docs the Leading Prescribers of Narcotic Painkillers: Study
- Abuse of Prescription Painkillers, Stimulants Ups Sexual Risks for Teens
- Prescription Meds: Too Common in Pregnancy?
- Who's Most Likely to Get Addicted to Their Narcotic Painkiller?
- Many Doctors Underestimate Risks of Prescription Painkillers: Survey
- It May Soon Be Possible to Easily 'Brew' Narcotics
- New Moms' Codeine Use Down Since Health Warnings
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- More U.S. Newborns Enduring Drug Withdrawal: Study
- Narcotic Painkillers in Pregnancy Common, Harmful to Baby: Study
- One-Quarter of Narcotic Painkillers Misused, Study Shows
- Big Increase Seen in Babies Born Addicted to Narcotics
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- Study Rates Migraine Medications
- Painkiller Tramadol Linked to Low Blood Sugar
- For a Child's Fracture, Use Ibuprofen, Not Morphine: Study
- Doctors' Group Issues Painkiller Guidelines
- U.S. to Tighten Access to Certain Narcotic Painkillers
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- Abuse of Prescription Painkillers on the Rise Among High School Athletes: Survey
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- 'Krokodil' Drug FAQ
- FDA Announces New Safety Measures for Narcotic Painkillers
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- Cough Medicine and Cough Syrups
- Codeine After Surgery Could Endanger Certain Kids: Study
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- Opioid Painkillers Linked to Birth Defects
- FDA Warns of Acetaminophen in Prescription Pain Drugs
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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.