Generic Name: codeine (KOE deen)
Brand Names:

What is codeine?

Codeine is an opioid pain medication. An opioid is sometimes called a narcotic.

Codeine is used to treat mild to moderately severe pain.

Codeine may also be used for purposes not listed in this medication guide.

Important information

You should not use codeine if you are allergic to it, or if you have an uncontrolled breathing disorder, a bowel obstruction called paralytic ileus, or frequent asthma attacks or hyperventilation.

Codeine can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Codeine may also be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. Keep the medicine in a place where others cannot get to it.

Slideshow: Prescription Drug Addiction - Are You at Risk?

MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.

Medicines that contain codeine should not be given to a child just after surgery to remove the tonsils or adenoids.

Get emergency medical help if a child taking this medication has breathing problems, blue lips, or severe drowsiness, or if you cannot wake the child up from sleep.

Before taking this medicine

You should not use codeine if you are allergic to it, or if you have:

  • untreated or uncontrolled asthma or other breathing disorder;

  • a bowel obstruction called paralytic ileus; or

  • frequent asthma attacks or hyperventilation.

Medicines that contain codeine should not be given to a child just after surgery to remove the tonsils or adenoids.

In some people, codeine breaks down rapidly in the liver and reaches higher than normal levels in the body. This can cause dangerously slow breathing and may cause death, especially in a child.

To make sure this medicine is safe for you, tell your doctor if you have:

  • liver disease;

  • asthma, COPD, sleep apnea, or other breathing disorders;

  • curvature of the spine that affects breathing;

  • kidney disease;

  • a history of head injury or brain tumor;

  • low blood pressure;

  • blockage in your digestive tract (stomach or intestines);

  • a gallbladder or pancreas disorder;

  • underactive thyroid;

  • Addison's disease or other adrenal gland disorder;

  • enlarged prostate, urination problems;

  • mental illness; or

  • a history of drug or alcohol addiction.

FDA pregnancy category C. It is not known whether this medicine will harm an unborn baby. Codeine may cause breathing problems, behavior changes, or life-threatening addiction and withdrawal symptoms in your newborn if you use the medication during pregnancy. Tell your doctor if you are pregnant.

See also: Pregnancy and breastfeeding warnings (in more detail)

Codeine can pass into breast milk and may harm a nursing baby. The use of codeine by some nursing mothers may lead to life-threatening side effects in the baby. Do not breast-feed while taking this medicine.

Older adults may be more sensitive to the effects of this medicine.

How should I take codeine?

Follow all directions on your prescription label. Codeine can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.

Codeine may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away codeine is against the law.

Take codeine with food or milk if it upsets your stomach.

Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.

Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking codeine. Do not use a stool softener (laxative) without first asking your doctor.

Do not stop using codeine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using this medicine.

Store at room temperature away from moisture and heat.

Keep track of the amount of medicine used from each new bottle. Codeine is a drug of abuse and you should be aware if anyone is using your medicine improperly or without a prescription.

After you have stopped using this medication, flush any unused pills down the toilet. Disposal of medicines by flushing is recommended to reduce the danger of accidental overdose causing death. This advice applies to a very small number of medicines only. The FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal and presents the least risk to human safety.

What happens if I miss a dose?

Since codeine is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. A codeine overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.

What should I avoid while taking codeine?

Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with codeine. Check your food and medicine labels to be sure these products do not contain alcohol.

Codeine may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.

See also: Codeine and alcohol (in more detail)

Codeine side effects

Get emergency medical help if you have any of these signs of an allergic reaction to codeine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Seek emergency medical attention if a child taking this medication has any of the following life-threatening side effects: noisy breathing, sighing, slow breathing with long pauses between breaths; being unusually sleepy or hard to wake up; blue colored lips.

Call your doctor at once if you have:

  • slow heart rate, weak pulse, fainting, shallow breathing;

  • feeling like you might pass out;

  • confusion, agitation, hallucinations, unusual thoughts or behavior;

  • feelings of extreme happiness or sadness;

  • seizure (convulsions); or

  • problems with urination.

Common codeine side effects include:

  • feeling dizzy or drowsy;

  • nausea, vomiting, stomach pain;

  • constipation;

  • sweating; or

  • mild itching or rash.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Codeine Dosing Information

Usual Adult Dose for Cough:

Initial dose: 15 mg orally every 6 hours as necessary.
May titrate up to 20 mg every 4 hours.
Maximum 120 mg/day.

Usual Adult Dose for Pain:

Initial dose: 30 mg orally, IM, subcutaneously, or IV every 6 hours as necessary. May titrate dose to achieve desired analgesic effect. Doses up to 60 mg orally, IM, subcutaneously, or IV every 4 hours have been used.

Usual Geriatric Dose for Cough:

Initial dose: 10 mg orally every 6 hours as necessary.
May titrate cautiously up to 20 mg every 4 hours.
Maximum 120 mg/day.

Usual Geriatric Dose for Pain:

Initial dose: 15 mg orally, IM, subcutaneously, or IV every 6 hours as necessary. May titrate dose to achieve desired analgesic effect. Doses up to 60 mg orally, IM, subcutaneously, or IV every 4 hours have been used.

Usual Pediatric Dose for Cough:

2 to 6 years: 2.5 to 5 mg orally every 4 to 6 hours
Maximum 30 mg/day

6 to 12 years: 5 to 10 mg orally every 4 to 6 hours
Maximum 60 mg/day

Usual Pediatric Dose for Pain:

1 year or greater: 0.5 mg/kg or 15 mg/m2 orally, IM, or subcutaneously every 4 to 6 hours as needed

What other drugs will affect codeine?

Taking this medicine with other drugs that make you sleepy or slow your breathing can cause dangerous or life-threatening side effects. Ask your doctor before taking codeine with a sleeping pill, other narcotic pain medicine, muscle relaxer, or medicine for anxiety, depression, or seizures.

Other drugs may interact with codeine, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about codeine.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use codeine only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2014 Cerner Multum, Inc. Version: 9.05. Revision Date: 2014-01-29, 3:05:57 PM.

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