Uses
What is codeine used for?
Codeine is commonly used to treat mild to moderate pain.
Codeine may also be used for other conditions as determined by your healthcare provider.
How does codeine work (mechanism of action)?
Codeine works by attaching to specific receptors in the body to reduce the feeling of pain.
How is codeine supplied (dosage forms)?
Dosage forms and strengths
- 15 mg, 30 mg, 60 mg oral tablets
How should I store codeine?
Codeine should be stored at room temperature, between 68 F to 77 F (20 C to 25 C). It can be exposed to temperatures between 59 F to 86 F (15 C to 30 C) for shorter periods of time, such as when transporting it. Store in a cool, dry place. Protect from light.
Side Effects
What are the most common side effects of codeine?
The most common side effects of codeine are listed below. Tell your healthcare provider if you have any of these side effects that bother you.
- Drowsiness or tiredness
- Lightheadedness or dizziness
- Headache
- Shortness of breath
- Stomach pain
- Nausea, vomiting, or constipation
- Sweating
There may be other side effects of codeine that are not listed here. Contact your healthcare provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088. In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.
What are the serious side effects of codeine?
While less common, the most serious side effects of codeine are described below, along with what to do if they happen.
Severe Allergic Reactions. Codeine may cause allergic reactions, which can be serious. Stop taking codeine and get help right away if you have any of the following symptoms of a serious allergic reaction.
- Breathing problems or wheezing
- Racing heart
- Fever or general ill feeling
- Swollen lymph nodes
- Swelling of the face, lips, mouth, tongue, or throat
- Trouble swallowing or throat tightness
- Itching, skin rash, or pale red bumps on the skin called hives
- Nausea or vomiting
- Dizziness, feeling lightheaded, or fainting
- Stomach cramps
- Joint pain
Risk of Misuse and Addiction. Misusing codeine can lead to serious side effects like coma or death. Misuse means taking a medicine in a way other than how it was prescribed. Take codeine exactly as prescribed. Tell your healthcare provider if you feel that codeine is not working. Call your healthcare provider right away or go to the nearest emergency room if you have any of the following serious symptoms.
- Sudden confusion or feeling disoriented
- Feeling paranoid
- Suicidal thoughts or actions
- Seizures
- Trouble breathing
Breathing Problems. Codeine may cause slow or shallow breathing, especially if you have breathing problems from another condition or take other medicines that can slow your breathing. Tell your healthcare provider if you develop severe sleepiness or trouble breathing, especially when you start codeine or when your dose is increased. Get emergency help if you have any of the following symptoms.
- Changes in the color of your skin, including bluish color to your lips and fingernails
- Confusion
- Shortness of breath
- Feeling dizzy, lightheaded, or fainting
- Changes in your heart rate or rhythm, such as a fast, slow, pounding or skipping heartbeat
- Slow or shallow breathing
- Excessive sleepiness or trouble staying awake
Increased Pain Sensitivity (Hyperalgesia). Codeine can cause an increased sensitivity to pain. It can cause things that normally cause pain to feel more painful than usual. Codeine can also cause allodynia. This happens when things that normally do not cause pain, such as wearing glasses or brushing your hair, become painful. If your pain increases, do not take extra doses of codeine. This could cause you to overdose or develop other serious side effects. Call your healthcare provider right away if your pain increases, you feel more sensitive to pain, or if you develop pain in other areas of the body.
Reduced Adrenal Function. Long-term use of codeine can cause your adrenal glands to stop making as much cortisol (the stress hormone). This is known as adrenal insufficiency. Adrenal insufficiency can get worse if your body is under stress because of fever, surgery, or trauma. Tell your healthcare provider if you have any of the following symptoms of adrenal insufficiency.
- Nausea and vomiting
- Weakness, tiredness, or lack of energy
- Low blood pressure
Low Blood Pressure (Hypotension). Codeine may cause low blood pressure. If you feel faint or dizzy, lie down. Tell your healthcare provider right away if you have any of the following symptoms of low blood pressure.
- Dizziness, feeling lightheaded, or fainting
- Confusion
- Feeling weak or tired
Sphincter of Oddi Spasm. The sphincter of Oddi is a muscular valve in your body that controls the flow of bile and digestive juices from the pancreas into the small intestine. When this valve spasms, it may feel like getting a tight muscle cramp, causing pain and blocking the flow of these juices, which can lead to discomfort and digestive problems. This is more likely to happen if you do not have a gallbladder. Stop taking codeine and get emergency help if you have new or worse stomach pain or pain in the upper right side of your stomach-area that travels to your back or shoulder, with or without nausea and vomiting.
Seizures. Codeine may cause seizures, especially if you have a seizure disorder. There are many different types of seizures and some of them are not easy to recognize. Stop taking codeine and call your healthcare provider if you have any of the following signs that a seizure is happening or could happen.
- Muscle twitching, jerking, spasms, tremors, or other uncontrolled movements
- Stiffening of your arms and legs
- Feeling anxious, nervous, confused, or a sense of dread
- Feeling dizzy or lightheaded
- Falling or losing consciousness
Warnings & Precautions
Who should not use codeine?
Allergies to Ingredients. People who are allergic to any of the following should not take codeine.
- Codeine
- Any of the ingredients in the specific product dispensed
Your pharmacist can tell you all of the ingredients in the specific codeine products they stock.
Children. Codeine should not be used in any child younger than 12 years of age or in a child younger than 18 years of age after a surgery to remove their tonsils or adenoids (tonsillectomy and/or adenoidectomy). Slow or shallow breathing that can lead to death may occur.
Gut Blockage. Codeine should not be used if you have a blockage of your gut (bowel obstruction) or a narrowing of the stomach or intestines. Codeine can make these conditions worse.
Slowed Gut Movement. Paralytic ileus is a type of ileus where your intestines are unable to move food through them. Codeine can make this condition worse.
Lung Problems. Codeine should not be used if you have severe asthma, trouble breathing, or other lung problems. Codeine can make these conditions worse.
Drug Interactions. Codeine should not be taken while you are using certain other medicines. Before taking codeine, tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using or have used recently. See the Interactions section for more details.
What should I know about codeine before using it?
Do not take codeine unless it has been prescribed to you by a healthcare provider. Take it as prescribed.
Do not share codeine with other people, even if they have the same condition as you. It may harm them.
Keep codeine out of the reach of children. Codeine is a controlled substance because it can be misused or lead to dependence. Store codeine in a safe place to protect it from theft. It is illegal to sell or give away this medicine.
Codeine can affect your alertness or coordination. Do not drive or do other activities that require alertness or coordination until you know how codeine affects you.
People who are 65 and older can be at greater risk for some side effects from codeine. Talk to your healthcare provider about your risks if you are in this age group.
Your healthcare provider may ask you to have naloxone, a medicine used to reverse the effects of codeine, on hand in case of an emergency. Make sure that you and a caregiver know how to use naloxone. If you have any questions, talk to your healthcare provider or pharmacist.
If you have been taking codeine on a regular basis, do not stop taking the medicine without talking to your healthcare provider. Stopping too quickly may cause serious side effects. Call your healthcare provider right away if you have any of the following symptoms.
- Feeling restless
- Watery eyes or runny nose
- Yawning
- Sweating or chills
- Muscle, joint, or back pain
- Dilated pupils
- Irritability, anxiety, or trouble sleeping
- Nausea, vomiting, diarrhea, or loss of appetite
- Increase in blood pressure, breathing rate, or heart rate
Dispose of expired, unwanted, or unused codeine right away by taking your medicine to an authorized DEA-registered collector or drug take back program. If one is not available, you can mix medicine with dirt, coffee grounds, or cat litter, then place the mixture in a sealed plastic bag and throw the bag in the trash.
Long-term use of codeine may affect your ability to become pregnant or get a partner pregnant. Talk with your healthcare provider if you have any concerns.
What should I tell my healthcare provider before using codeine?
Tell your healthcare provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them determine if codeine is right for you.
In particular, make sure that you discuss any of the following.
Current and Past Health Conditions. Tell your healthcare provider if you have any of the following.
- Head injury or brain problems, such as brain tumors or increased pressure around the brain
- Seizures
- Liver, kidney, or thyroid problems
- Pancreas or gallbladder problems
- Breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)
- Obstructive sleep apnea
- Problems peeing
- Abuse of street drugs or prescription medicines or living with someone who has this problem
- Alcohol addiction
- Opioid overdose
- Mental health problems
- Diabetes
- Recent or upcoming surgery to remove your tonsils or adenoids
- Have been told by your healthcare provider that you are a rapid metabolizer of certain medicines
Pregnancy. Codeine may cause harm to an unborn baby. Tell your healthcare provider if you are or plan to become pregnant. Your healthcare provider will advise you if you should take codeine while you are pregnant or trying to get pregnant. If you take codeine on a regular basis during pregnancy, your baby may have withdrawal symptoms that can be life-threatening. Tell your healthcare provider if you took codeine during your pregnancy, especially near the end of your pregnancy.
Breastfeeding. Do not take codeine while you are breastfeeding. Codeine can pass into breast milk. Tell your healthcare provider if you are breastfeeding or plan to breastfeed.
Interactions
Does codeine interact with foods or drinks?
There are no known interactions between codeine and foods or non-alcoholic drinks.
Do not drink alcohol or use prescription or over-the-counter medicines that contain alcohol. Using alcohol while taking codeine can cause you to overdose and die.
Does codeine interact with other medicines (drug interactions)?
Always tell your healthcare provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using.
In particular, make sure that you discuss if you are using any of the following before taking codeine.
- A monoamine oxidase inhibitor (MAOI) within the past 2 weeks, which is a medicine usually used for depression or Parkinson’s disease
- A benzodiazepine, such as clonazepam (Klonopin), diazepam (Valium and others), or lorazepam (Ativan and others), which is a medicine used for anxiety, muscle spasms, or seizures
- Any medicine that affects serotonin in your body, such as medicines for depression, anxiety, or certain mental health conditions, some migraine medicines, and some medicines for nausea and vomiting.
- A macrolide antibiotic, such as clarithromycin or erythromycin (Ery-Tab and others), which is a medicine used for bacterial infections
- Ketoconazole, itraconazole (Sporanox, Tolsura), posaconazole (Noxafil), fluconazole (Diflucan), or voriconazole (Vfend), which is a medicine used for fungal infections
- A protease inhibitor, such as ritonavir (Norvir) or nelfinavir (Viracept), which is a medicine commonly used to treat HIV
- Rifampin, which is a medicine commonly used to treat an infection called tuberculosis
- Carbamazepine or phenytoin, which is a medicine used for seizures
- A mixed agonist/antagonist or partial agonist opioid analgesic, such as buprenorphine (Butrans, Sublocade), butorphanol, and others, which is a medicine used to treat certain types of pain or opioid use disorder
- A diuretic, also called a water pill, which is a medicine used to reduce edema (fluid retention) and blood pressure
- An anticholinergic medicine, which includes antihistamines and medicines commonly used for overactive bladder, Parkinson’s disease, or stomach problems
- Any other medicine that causes dizziness and sleepiness, such as prescription pain medicines, sleep medicines, muscle relaxants, and medicines for anxiety
Many other medicines may alter the blood levels of codeine. Tell your healthcare provider about all medicines that you take or have recently taken.
This may not be a complete list of medicines that can interact with codeine. Always check with your healthcare provider.
Overdose/Missed Dose
What should I do if I accidentally use too much codeine?
If you or someone else has used too much codeine, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.
What should I do if I miss a dose of codeine?
If you miss a dose, skip the missed dose and only take the next dose at your usual time. Do not take double or extra doses.
Are you currently using Codeine?
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