Codeine Side Effects
Some side effects of codeine may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.
For the Consumer
Applies to codeine: oral solution, oral syrup, oral tablet, oral tablet extended release
Along with its needed effects, codeine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Check with your doctor immediately if any of the following side effects occur while taking codeine:Incidence not known
- blurred vision
- cold, clammy skin
- darkened urine
- difficult or troubled breathing
- dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position
- fast, irregular, pounding, or racing heartbeat or pulse
- fast, weak pulse
- feeling of warmth
- irregular, fast or slow, or shallow breathing
- loss of appetite
- no blood pressure or pulse
- no breathing
- pains in the stomach, side, or abdomen, possibly radiating to the back
- pale or blue lips, fingernails, or skin
- redness of the face, neck, arms, and occasionally, upper chest
- shortness of breath
- stopping of the heart
- unusual tiredness or weakness
- yellow eyes or skin
Get emergency help immediately if any of the following symptoms of overdose occur while taking codeine:Symptoms of overdose
- Bluish lips or skin
- change in consciousness
- chest pain or discomfort
- constricted, pinpoint, or small pupils (black part of the eye)
- decreased awareness or responsiveness
- extreme sleepiness or unusual drowsiness
- loss of consciousness
- no blood pressure or pulse
- severe sleepiness
- slow or irregular heartbeat
Some side effects of codeine may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:More common
- relaxed and calm
- Abdominal or stomach pain or cramps
- blurred or loss of vision
- disturbed color perception
- double vision
- dry mouth
- false or unusual sense of well-being
- fear or nervousness
- feeling of constant movement of self or surroundings
- halos around lights
- hives or welts
- itching skin
- night blindness
- overbright appearance of lights
- redness of the skin
- sensation of spinning
- skin rash
- trouble sleeping
- tunnel vision
- unable to sleep
- weight loss
For Healthcare Professionals
Applies to codeine: compounding powder, injectable solution, oral solution, oral tablet
The side effects have been more likely and more severe in patients with liver and/or renal disease.
Nervous system side effects have included mental and respiratory depression, stupor, delirium, somnolence, and dysphoria. An increased risk of falls and hip fractures has also been associated with codeine therapy, particularly in the elderly. A case of seizures has been reported with the use of intravenous codeine phosphate.
Opioids may result in psychotic symptoms in some patients.
One retrospective study of elderly patients who sustained a hip fracture suggested that the relative risk of hip fracture was 1.6 in patients using codeine compared to age matched nonusers.
Other side effects including withdrawal symptoms after either abrupt cessation or fast tapering of narcotic analgesics have been reported. These withdrawal symptoms have included agitation, restlessness, anxiety, insomnia, tremor, abdominal cramps, blurred vision, vomiting, and sweating.
Hypotension is rare and has been reported most frequently with high doses.
Cardiovascular side effects have included hypotension and dizziness.
Gastrointestinal side effects including nausea, vomiting, and constipation have been reported frequently. Severe constipation and ileus resulting in colonic perforation have also been reported. Four cases of acute pancreatitis have been reported.
Genitourinary side effects including urinary retention have been reported.
Dermatologic side effects including rashes, severe scarlatiniform eruptions, and generalized dermatitis have been reported rarely.
Codeine induced rashes may be related to direct stimulation of histamine release.
Renal side effects including acute renal failure (which may respond to naloxone therapy) have been reported in association with codeine therapy.
Immunologic side effects have included one study of a patient with exercise induced anaphylaxis and three control subjects which found a correlation between codeine wheal size and recent exercise.
Hypersensitivity side effects including a case of codeine phosphate induced hypersensitivity syndrome have been reported.
Ocular side effects including a temporary 26% decrease in pupil diameter following the administration of intravenous codeine have been reported.
Respiratory side effects have included respiratory depression.
More codeine resources
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