Codeine vs. Vicodin

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

What is the difference between codeine and Vicodin?

What are codeine and Vicodin?

Codeine is an opioid pain reliever, similar to morphine, indicated for the relief of mild to moderately severe pain where the use of an opioid analgesic is appropriate. It is also sometimes used as a cough suppressant. The precise mechanism of the pain relieving action of codeine is unknown, but it binds to receptors in the brain and can increase tolerance to pain, which decreases discomfort.

Vicodin contains a combination of a non-narcotic pain reliever (acetaminophen) and an opioid analgesic (hydrocodone). Acetaminophen helps increase the effects of hydrocodone. Vicodin is used for the relief of moderate to moderately severe pain.

Are codeine and Vicodin addictive?

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.

You need a prescription for codeine. Codeine is a schedule II controlled substance in the US.

Hydrocodone may be habit forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief.

What are the side effects of codeine and Vicodin?

Codeine

The most frequent side effects of codeine include:

Serious side effects of codeine include:

Vicodin

Common side effects of hydrocodone/acetaminophen are:

  • lightheadedness,
  • dizziness,
  • sedation,
  • nausea, and
  • vomiting.
Other important side effects include:
  • drowsiness,
  • constipation, and
  • spasm of the ureter, which can lead to difficulty in urinating.

Hydrocodone can impair thinking and the physical abilities required for driving or operating machinery. Hydrocodone can depress breathing, and should be used with caution in elderly, debilitated patients and in patients with serious lung disease.

Hydrocodone may be habit forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief.

Acetaminophen can cause severe liver failure if excessive amounts are used and when combined with chronic alcohol use or other drugs that also impair liver function.

What is the dosage of codeine vs. Vicodin?

Codeine

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.

Vicodin

The usual dose for adults is 1 to 2 tablets or capsules (hydrocodone 2.5 to 10 mg; acetaminophen 300 to 750 mg) every 4 to 6 hours or 15 mL of liquid every 4 to 6 hours as needed.

QUESTION

Medically speaking, the term "myalgia" refers to what type of pain? See Answer

What drugs interact with codeine and Vicodin?

Both codeine and Vicodin 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 or Vicodin. Therefore, alcohol and other sedatives should not be used when taking either drug.

Drugs that stimulate and also block opioid receptors (for example, pentazocine) reduce the effect of both codeine and Vicodin. Such drugs should not be combined with either.

Drugs that block the action of acetylcholine (anticholinergic drugs) increase the occurrence of urinary retention and constipation when combined with codeine or Vicodin.

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 and Vicodin. Neither codeine nor Vicodin should be used in patients taking MAOIs or within 14 days of stopping MAOIs.

Is it safe to take codeine or Vicodin 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.

There are no adequate studies of hydrocodone and acetaminophen in pregnant women.

Hydrocodone/acetaminophen is excreted in breast milk, and, therefore should be used cautiously by nursing mothers.

Summary

Codeine is an opioid pain reliever and cough suppressant. Vicodin is a different type of opioid pain reliever and cough suppressant combined with the non-opioid pain reliever acetaminophen. These drugs are prescribed for conditions that cause acute pain and for some kinds of severe coughs. Both can be addictive and neither should be taken with alcohol. Read more about drug interactions, dosage and side effects of codeine vs. Vicodin.

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