Codeine

Prescription Drug Information

Codeine: Uses, Dosage, Side Effects & Warnings

Codeine is a prescription opioid analgesic and cough suppressant first approved in the United States in 1950. This comprehensive guide covers everything patients and caregivers need to know about safe and effective use.

Opioid / Narcotic Analgesic Prescription Only Not for use in patients under 18
 
!
Important Warning
Codeine may be habit-forming. Take it exactly as prescribed. Do not increase your dose, take it more frequently, or use it in a different way than directed by your doctor. Codeine can cause serious or life-threatening breathing problems, especially within the first 24 to 72 hours of treatment and after any dose increase. Seek emergency care immediately if you notice slowed or difficult breathing. If you think you have developed an opioid addiction, contact SAMHSA’s National Helpline at 1-800-662-HELP.

What Is Codeine?

Codeine is a prescription opioid (narcotic) analgesic belonging to the opiate class of medications. It was originally approved in the United States in 1950 and works by increasing the body’s threshold for pain — changing the way the brain and nervous system respond to painful stimuli. Codeine is also classified as an antitussive, meaning it reduces coughing by decreasing activity in the brain’s cough center. It is available as a standalone medication and as an ingredient in many combination cough and cold products.

What Is Codeine Used For?

Codeine is primarily prescribed for two conditions:

1. Pain Relief

Codeine is used to relieve mild to moderate pain. It alters how the brain and nervous system process pain signals to provide short-term relief. It is not typically recommended for long-term or chronic pain management.

2. Cough Suppression

When used as a cough suppressant, codeine decreases activity in the part of the brain responsible for triggering the cough reflex. It is commonly combined with other medications such as guaifenesin or promethazine in cough formulations.
Note: Codeine relieves symptoms but does not treat the underlying cause of pain or illness, nor does it speed up recovery.
Codeine is also available in combination with acetaminophen (Tylenol with Codeine), aspirin, carisoprodol, and promethazine. If you are taking a combination product, read the full information for all ingredients.

How to Take Codeine

Codeine is available as a tablet, capsule, or oral solution (liquid) and is typically taken every 4 to 6 hours as needed. Always follow the instructions on your prescription label carefully.

Dosage Tips

  • Use the measuring cup or spoon provided with liquid forms — never a regular household spoon.
  • Shake the oral solution well before each use.
  • Do not take a larger dose or use it more often than prescribed.
  • Never take a double dose to make up for a missed one.

Stopping Codeine Safely

Do not stop taking codeine suddenly after several weeks or more of use. Your doctor should reduce your dose gradually to prevent withdrawal. Abrupt discontinuation may cause:
Restlessness Anxiety Sweating Nausea & Vomiting Diarrhea Muscle Aches Insomnia Runny Nose Fast Heartbeat

Important Warnings & Safety Information

Risk of Breathing Problems

Codeine can cause life-threatening respiratory depression, particularly within the first 24–72 hours of starting treatment or after a dose increase. Patients with asthma, COPD, head injury, or brain tumors are at higher risk and should consult their doctor carefully before use.
!
Seek Emergency Help If You Notice:
Slowed or shallow breathing, long pauses between breaths, or shortness of breath. Call 911 or go to the nearest emergency room immediately.

Not Safe for Children Under 18

Codeine is never recommended for patients under 18 years of age for pain or cough treatment. Serious breathing problems and deaths have been reported in children given codeine. If your child is prescribed a cough product containing codeine, talk to their doctor immediately about safer alternatives.

Habit-Forming Potential & Addiction Risk

Codeine carries a significant risk of dependence and addiction, especially with prolonged use. Individuals with a history of alcohol misuse, substance use disorder, depression, or other mental illness face a higher risk of overuse. Discuss your full medical history openly with your healthcare provider. 📞 SAMHSA Helpline: 1-800-662-HELP

Alcohol Warning

⚠
Do Not Drink Alcohol
Do not consume alcohol or use prescription or nonprescription medications containing alcohol while taking codeine. Alcohol significantly increases the risk of dangerous side effects, including respiratory depression, coma, and death.

Pregnancy & Breastfeeding

Regular use of codeine during pregnancy may cause life-threatening withdrawal symptoms in the newborn after birth. Symptoms in infants include irritability, abnormal sleep, high-pitched crying, vomiting, and failure to gain weight. Codeine should also not be used while breastfeeding, as it can cause breathing difficulties, excessive sleepiness, and limpness in breastfed infants.

Drug Interactions

Codeine interacts with many medications. Always inform your doctor and pharmacist about every drug, supplement, and herbal product you are taking. Critical interactions include:
  • MAO inhibitors (e.g., phenelzine, selegiline)
  • Benzodiazepines (e.g., Valium, Xanax, Ativan)
  • Antifungals (e.g., ketoconazole)
  • Antibiotics (e.g., erythromycin)
  • HIV medications (e.g., ritonavir, indinavir)
  • SSRIs & SNRIs (antidepressants)
  • Tricyclic antidepressants
  • Muscle relaxants & sedatives
  • Sleeping pills & tranquilizers
  • Seizure medications (e.g., phenytoin, carbamazepine)
  • Rifampin
  • St. John’s Wort (herbal supplement)
Do not take codeine within 2 weeks of stopping an MAO inhibitor. Combining codeine with any of the above drugs may cause extreme drowsiness, slowed breathing, coma, or death.

Side Effects of Codeine

Common Side Effects

Tell your doctor if any of the following become severe or persistent:
  • Headache
  • Stomach pain
  • Difficulty urinating
  • Constipation
  • Dizziness or lightheadedness when standing
  • Drowsiness

Serious Side Effects — Seek Immediate Medical Attention

Stop taking codeine and call your doctor right away or get emergency care if you experience:
  • Slowed, shallow, or noisy breathing
  • Agitation, hallucinations, fever, or severe muscle twitching (signs of serotonin syndrome)
  • Seizures
  • Irregular heartbeat or changes in heartbeat
  • Changes in vision
  • Severe allergic reactions: rash, hives, itching, or difficulty swallowing
  • Extreme nausea, vomiting, weakness, or dizziness
  • Decreased sexual desire or irregular menstruation
Report any unusual side effects to the FDA MedWatch program online at fda.gov/Safety/MedWatch or by phone at 1-800-332-1088.

Overdose & Emergency Information

!
In Case of Overdose
Call Poison Control immediately at 1-800-222-1222, or visit poisonhelp.org. If the person has collapsed, is having a seizure, cannot breathe, or cannot be awakened — call 911 immediately.

Signs of Codeine Overdose

Slow or shallow breathing Extreme drowsiness Unable to wake up Cold, clammy skin Fainting Slow heartbeat Loss of muscle tone Dizziness

Naloxone — Overdose Rescue Medication

Ask your doctor about keeping naloxone at home. Naloxone reverses life-threatening opioid overdose effects by blocking opiates in the blood. It is especially recommended for households with small children or individuals with a history of substance use. Make sure your family members or caregivers know how to recognize overdose symptoms and how to administer naloxone. Additional doses can be given every 2–3 minutes until emergency help arrives.

Special Precautions Before Taking Codeine

Before starting codeine, inform your doctor if you have ever had any of the following:
  • Liver or kidney disease
  • Thyroid or gallbladder disease
  • Addison’s disease
  • Seizures or mental illness
  • Low blood pressure
  • Head injury or brain tumor
  • Enlarged prostate or urinary problems
  • Recent abdominal surgery
  • Blockage in the stomach or intestines
  • Paralytic ileus
i
Fertility Notice
Codeine may reduce fertility in both men and women. Discuss this with your doctor if you are planning to conceive.
Codeine may cause drowsiness and dizziness. Do not drive or operate machinery until you know how it affects you. When getting out of bed, rise slowly to reduce the risk of lightheadedness or fainting.

Storage & Disposal

Store codeine in its original, tightly closed container at room temperature, away from excess heat and moisture (not in the bathroom). Keep it out of sight and reach of children at all times. Do not flush codeine down the toilet. Dispose of unused medication through a medicine take-back program — ask your pharmacist or visit the FDA Safe Disposal of Medicines website for local options.

Frequently Asked Questions About Codeine

Is codeine an opioid?

Yes. Codeine is a prescription opioid analgesic that works on opioid receptors in the brain and nervous system to reduce the perception of pain and suppress coughing.

Can codeine be used for a cough?

Yes, but only in adults aged 18 and over. Codeine suppresses the cough reflex and is sometimes prescribed for persistent cough, usually in combination with other medications. It is not approved for cough use in anyone under 18 due to serious breathing risks.

How long does codeine stay in your system?

Codeine is typically detectable in urine for 24 to 48 hours. Detection times vary based on individual metabolism, dosage, frequency of use, and other factors such as hydration and kidney function.

What is the maximum safe dose of codeine?

Dosing is individually determined by your doctor based on your condition and medical history. Never self-adjust your dose. Always follow your prescribed guidelines exactly.

Can I take codeine with ibuprofen or acetaminophen?

Codeine is sometimes prescribed in combination with acetaminophen (e.g., Tylenol with Codeine). Always consult your doctor or pharmacist before combining codeine with any other pain reliever to avoid dangerous interactions or accidental overdose.

Is codeine available over the counter?

In the United States, codeine is a controlled Schedule II or III substance depending on the formulation and is only available with a valid prescription. Laws vary in other countries.
Medical Disclaimer: This article is intended for general informational and educational purposes only. It does not constitute medical advice and is not a substitute for professional consultation with a licensed healthcare provider. Always consult your doctor or pharmacist before starting, changing, or stopping any prescription medication including codeine. In case of a medical emergency, call 911 or your local emergency services immediately.

Buy Codeine

What Are the Risks of Taking Codeine?

Codeine is an opioid medication used to treat pain and suppress coughing. While effective, it carries serious health risks, especially when used incorrectly or for long periods.

Breathing Problems

One of the most dangerous risks linked to codeine is slowed or difficult breathing. Opioids affect the part of the brain that controls respiration. In high doses, or when mixed with other sedatives, breathing may become dangerously slow or stop completely.

Driving and Operating Machinery

Codeine can cause:

  • Drowsiness

  • Reduced concentration

  • Slower reaction time

  • Dizziness

These effects increase the risk of accidents while driving or operating machinery. The risk is often higher when starting treatment or increasing dosage. Some insurance providers may also limit coverage if an accident occurs while taking opioid medication.

Kidney and Liver Concerns

People with liver or kidney problems may process codeine more slowly. This can increase drug levels in the body and raise the risk of side effects or overdose. Doctors often review organ function before prescribing opioid medications.

Interactions With Alcohol and Other Drugs

Combining codeine with alcohol or sedative medications such as benzodiazepines increases the risk of:

  • Severe drowsiness

  • Breathing difficulties

  • Loss of consciousness

  • Overdose

Mixing these substances can become life-threatening.

Tolerance and Dependence

With repeated use, the body may develop tolerance. This means larger doses are needed to achieve the same effect. Higher doses also increase the risk of side effects and overdose.

Dependence can develop even when codeine is taken exactly as prescribed. Some people may also develop addiction, where use becomes difficult to control despite harmful effects.

Signs of possible dependence include:

  • Cravings for the medication

  • Needing higher doses

  • Withdrawal symptoms when stopping

  • Continued use despite problems

Codeine Overdose

Taking too much codeine can lead to overdose, which is a medical emergency. Opioid overdose affects breathing and brain function.

Common signs include:

  • Extreme sleepiness

  • Slow or shallow breathing

  • Loss of consciousness

  • Very small pupils

  • Unresponsiveness

Emergency medical help should be sought immediately if overdose is suspected.

Naloxone and Overdose Reversal

Naloxone is a medication used to temporarily reverse the effects of opioid overdose. It works by blocking opioid receptors and restoring breathing. In many regions, naloxone is available without prescription for emergency use.

Safe Use Guidelines

To reduce risk:

  • Follow prescribed doses carefully

  • Avoid alcohol

  • Do not mix with sedatives unless medically advised

  • Avoid increasing dose without supervision

  • Store medication safely

summary

Codeine has legitimate medical uses, but it also carries significant risks. Careful monitoring and responsible use reduce the chance of harm, dependence, and overdose.

For external references 

https://medlineplus.gov/druginfo/meds/a682065.html

https://www.healthdirect.gov.au/codeine

https://www.ncbi.nlm.nih.gov/books/NBK526029/

https://www2.hse.ie/medicines/codeine/how-to-take/

 

Granie w kasynie mobilnym stało się prostsze i bezpieczniejsze dzięki aplikacji na smartfony i tablety, gdzie mostbet bonus zachęca do odkrywania licznych gier i nagród.