Codeine Medication Information

Codeine is a prescription opioid medication that may be used to relieve certain types of pain and, in some prescription products, to reduce coughing.

Codeine works primarily through opioid receptors. Some of its effects also depend on how the body metabolizes codeine into morphine. Differences in metabolism can affect how strongly a person responds to the medication.

Because codeine is an opioid, it carries important risks, including misuse, abuse, addiction, respiratory depression, overdose, and death. FDA has also established important restrictions involving codeine use in children and warnings concerning breastfeeding. citeturn0search0turn0search28

What Is Codeine?

Codeine is an opioid medication used in certain prescription products.

It may be available as a single ingredient or combined with other medications, including acetaminophen. Codeine has also been included in some prescription cough and cold medicines. citeturn0search0

The appropriate use of codeine depends on the specific product, the patient’s medical condition, age, other medications, and applicable prescribing information.

What Is Codeine Used For?

Codeine may be prescribed for certain types of pain. It may also be included in some prescription medications intended to reduce coughing. citeturn0search0

For pain treatment, healthcare professionals consider whether an opioid is appropriate and whether alternative treatments provide adequate relief.

For cough treatment, the specific product and patient age are especially important because FDA has restricted the use of prescription opioid cough and cold medicines containing codeine in people younger than 18. citeturn0search2

How Does Codeine Work?

Codeine works primarily by interacting with opioid receptors in the central nervous system.

Some codeine is converted by the body into morphine through an enzyme called CYP2D6.

This is important because people can metabolize codeine differently.

Some people may convert codeine into morphine more quickly than expected, potentially increasing opioid effects and the risk of serious adverse reactions.

Others may metabolize it more slowly and experience less pain relief.

Codeine and CYP2D6 Metabolism

CYP2D6 is an enzyme involved in the conversion of codeine into morphine.

Genetic differences can cause people to metabolize codeine differently.

A person who is an ultrarapid metabolizer may convert codeine to morphine more quickly, which can result in higher morphine exposure and an increased risk of opioid toxicity.

This is one reason codeine has important safety restrictions, particularly in children. FDA has warned about serious breathing problems and deaths associated with codeine in certain pediatric patients. citeturn0search24turn0search28

Codeine Dosage Information

The appropriate codeine dose depends on the specific prescription product and the individual patient.

Factors that may affect treatment include:

  • Age
  • Medical condition
  • Type and severity of symptoms
  • Other medications
  • Previous opioid exposure
  • Kidney function
  • Liver function
  • Respiratory conditions
  • Individual response to treatment

Patients should take codeine exactly as prescribed.

Do not take more codeine, take it more frequently, or use another person’s prescription.

The dosing instructions for one codeine product may not apply to another product, especially when codeine is combined with another active ingredient.

Codeine Side Effects

Possible side effects of codeine may include:

  • Drowsiness
  • Dizziness
  • Nausea
  • Vomiting
  • Constipation
  • Stomach discomfort
  • Headache
  • Dry mouth
  • Sweating
  • Lightheadedness

Side effects can vary depending on the person and the specific product.

Contact a healthcare professional if side effects are severe, persistent, or interfere with normal activities.

Serious Codeine Side Effects

Codeine can cause serious and potentially life-threatening adverse effects.

Seek immediate medical attention for:

  • Slow or difficult breathing
  • Severe sleepiness
  • Difficulty waking
  • Loss of consciousness
  • Severe confusion
  • Severe allergic reaction
  • Blue or gray lips or skin
  • Signs of opioid overdose

Opioids can suppress the central nervous system and reduce breathing. FDA identifies respiratory depression, misuse, abuse, addiction, overdose, and death as important opioid safety risks. citeturn0search5

Codeine and Respiratory Depression

Respiratory depression occurs when breathing becomes too slow or ineffective.

Codeine can cause serious respiratory depression, particularly when taken in excessive amounts or combined with other substances that depress the central nervous system.

Warning signs may include:

  • Slow breathing
  • Shallow breathing
  • Difficulty breathing
  • Extreme sleepiness
  • Difficulty waking
  • Loss of consciousness

If someone taking codeine develops severe breathing problems or cannot be awakened, call 911 immediately.

Codeine and Alcohol

Alcohol can increase the sedating effects of codeine.

Combining alcohol with an opioid can increase the risk of:

  • Severe drowsiness
  • Impaired coordination
  • Respiratory depression
  • Loss of consciousness
  • Overdose

Patients should discuss alcohol use with their healthcare professional and avoid combinations that could increase opioid-related risks.

Codeine and Benzodiazepines

Benzodiazepines include medications such as:

  • Alprazolam
  • Clonazepam
  • Diazepam
  • Lorazepam

Combining opioids with benzodiazepines or other central nervous system depressants can increase the risk of profound sedation, respiratory depression, coma, and death.

Tell your doctor and pharmacist about all medications you take before using codeine.

Codeine Drug Interactions

Codeine can interact with prescription medications, over-the-counter medicines, and other substances.

Potentially important interactions may include:

  • Benzodiazepines
  • Other opioids
  • Alcohol
  • Sedatives
  • Sleeping medications
  • Other central nervous system depressants
  • Certain antidepressants
  • Medicines that affect CYP2D6
  • Medicines that affect CYP3A4

Some medications can alter codeine metabolism and change the amount of opioid activity produced in the body.

Always provide a complete medication list to your healthcare professional and pharmacist.

Codeine Dependence

Regular opioid use can cause physical dependence.

Physical dependence means that the body adapts to continued exposure to the medication.

Dependence is different from addiction, although codeine also carries a risk of misuse, abuse, and addiction.

Use codeine only according to the prescription and never share it with another person.

Codeine Withdrawal

People who have used codeine regularly for an extended period may experience withdrawal if treatment is stopped suddenly.

Possible withdrawal symptoms include:

  • Anxiety
  • Restlessness
  • Sweating
  • Muscle aches
  • Insomnia
  • Runny nose
  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Chills
  • Irritability

Do not suddenly stop long-term opioid treatment without discussing the appropriate plan with a healthcare professional.

Codeine Overdose

Taking too much codeine can result in a potentially fatal opioid overdose.

Possible symptoms include:

  • Extreme sleepiness
  • Slow or difficult breathing
  • Very small pupils
  • Weakness
  • Loss of consciousness
  • Coma
  • Death

If you suspect an opioid overdose, call 911 immediately.

Naloxone may be used as an emergency opioid reversal medication. Emergency medical care is still necessary even when naloxone is available.

Codeine and Naloxone

Naloxone can temporarily reverse the effects of an opioid overdose.

People who use prescription opioid medications may wish to ask their healthcare professional or pharmacist whether naloxone should be available in their household.

Naloxone is not a replacement for emergency medical treatment.

Codeine and Driving

Codeine may cause drowsiness, dizziness, impaired concentration, and slower reaction time.

Do not drive or operate machinery until you know how codeine affects you.

Avoid driving if you feel sleepy, dizzy, confused, or impaired.

The risk of impairment may increase when codeine is combined with alcohol, benzodiazepines, sleeping medications, or other sedating substances.

Codeine in Children

Codeine has significant pediatric safety restrictions.

FDA states that codeine should not be used to treat pain or cough in children younger than 12 years. FDA also recommends against codeine use for cough in people younger than 18 because prescription opioid cough and cold medicines containing codeine or hydrocodone are restricted to adults. citeturn0search28turn0search2

Children and adolescents with certain medical conditions may also face increased respiratory risk.

Parents and caregivers should never give a child’s medication containing codeine unless it has been specifically prescribed and directed by a qualified healthcare professional.

Codeine and Breastfeeding

FDA recommends against breastfeeding during treatment with codeine because codeine can pass into breast milk and may cause serious adverse effects in a breastfed infant.

Potential infant complications include:

  • Excessive sleepiness
  • Difficulty feeding
  • Respiratory depression
  • Serious opioid toxicity
  • Death

The risk may be greater when a mother is an ultrarapid metabolizer of codeine. citeturn0search24turn0search28

People who are pregnant or breastfeeding should discuss all opioid medications with their healthcare professional.

Codeine During Pregnancy

Tell your healthcare professional if you are pregnant, planning pregnancy, or become pregnant while taking codeine.

Long-term opioid exposure during pregnancy can result in neonatal opioid withdrawal syndrome.

A healthcare professional can evaluate the potential benefits and risks of treatment and determine the safest approach.

Do not abruptly stop long-term opioid treatment during pregnancy without medical guidance.

Codeine and Older Adults

Older adults may be more sensitive to the effects of opioid medications.

Healthcare professionals may consider:

  • Age
  • Kidney function
  • Liver function
  • Other medications
  • Fall risk
  • Breathing problems
  • Overall health

Older adults should report unusual sleepiness, dizziness, confusion, or breathing difficulties.

Codeine and Kidney or Liver Problems

Kidney and liver function can affect medication handling and treatment decisions.

Tell your healthcare professional if you have:

  • Kidney disease
  • Liver disease
  • Hepatitis
  • Cirrhosis
  • Abnormal liver tests
  • Other significant medical conditions

Additional monitoring or treatment adjustments may be appropriate depending on the individual patient and product.

Codeine and Combination Medications

Codeine is available in some combination prescription products.

For example, certain products combine codeine with acetaminophen.

When codeine is combined with another active ingredient, patients need to consider the safety information for all ingredients, not just codeine.

This is particularly important with acetaminophen-containing products because taking multiple medicines containing acetaminophen can increase the risk of excessive acetaminophen exposure and liver injury.

Always check prescription and over-the-counter medication labels and ask a pharmacist if you are unsure about overlapping ingredients.

Safe Storage of Codeine

Codeine should be stored securely.

Important precautions include:

  • Keep it out of sight and reach of children.
  • Do not share it with anyone.
  • Keep it away from visitors and other unauthorized people.
  • Follow the storage instructions provided with the medication.
  • Dispose of unused medication according to appropriate disposal guidance.

FDA recommends secure storage of opioid pain medicines to reduce accidental exposure, misuse, and overdose. citeturn0search5

Who Should Tell Their Doctor Before Taking Codeine?

Tell your healthcare professional if you have:

  • Breathing problems
  • Asthma
  • Sleep apnea
  • Kidney disease
  • Liver disease
  • A history of opioid use
  • Substance use disorder
  • Head injury
  • Severe constipation
  • A history of medication reactions

Also tell your healthcare professional about all prescription medications, over-the-counter medicines, supplements, and substances you use.

Codeine Prescription Information

Codeine is available in prescription medications used for certain medical conditions.

The exact regulatory status can depend on the specific formulation and combination product.

For example, current DailyMed labeling for an acetaminophen/codeine phosphate tablet identifies a Schedule II product, while another current acetaminophen/codeine product is classified as Schedule III. citeturn0search3turn0search4

Patients should follow the prescription and pharmacy requirements applicable to the exact product they have been prescribed.

Codeine at Maxson Pharmacy

Maxson Pharmacy provides medication-information resources designed to help readers understand prescription medications, including their uses, precautions, side effects, interactions, and safety considerations.

If you have questions about codeine, a codeine-containing prescription, possible interactions, or whether a medication is appropriate for you, speak with a qualified healthcare professional or pharmacist.

Frequently Asked Questions About Codeine

What is codeine?

Codeine is an opioid medication used in certain prescription products for pain and, in some formulations, cough.

Is codeine an opioid?

Yes. Codeine is an opioid medication.

What is codeine used for?

Codeine may be used in certain prescription products to treat pain. It has also been used in prescription cough medicines, although FDA has significantly restricted pediatric use of opioid cough and cold products containing codeine. citeturn0search0turn0search2

Can codeine cause addiction?

Yes. Codeine is an opioid and carries risks of misuse, abuse, addiction, overdose, and death. citeturn0search5

Can codeine cause respiratory depression?

Yes. Codeine can cause serious or potentially fatal respiratory depression, particularly when excessive amounts are taken or when it is combined with other central nervous system depressants.

Can codeine be taken with alcohol?

Alcohol can increase the sedating and respiratory-depressant effects of codeine. Discuss alcohol use with your healthcare professional.

Can codeine be taken with benzodiazepines?

Combining codeine with benzodiazepines can increase the risk of severe sedation and respiratory depression. Tell your healthcare professional about all medications you take.

Can codeine cause withdrawal?

Yes. Regular opioid use can cause physical dependence, and sudden discontinuation may produce withdrawal symptoms.

Can codeine cause an overdose?

Yes. A codeine overdose can cause severe respiratory depression, loss of consciousness, coma, and death.

Can children take codeine?

FDA states that codeine should not be used to treat pain or cough in children younger than 12 years. Prescription opioid cough and cold medicines containing codeine are limited to adults 18 and older. citeturn0search28turn0search2

Can codeine be used while breastfeeding?

FDA recommends against breastfeeding while taking codeine because of the risk of serious adverse reactions in the breastfed infant, including excessive sedation, respiratory depression, and death. citeturn0search28

Does codeine affect everyone the same way?

No. Genetic differences in CYP2D6 metabolism can affect how the body converts codeine to morphine, which can influence both effectiveness and safety.

Should naloxone be available when taking codeine?

Ask your healthcare professional or pharmacist whether naloxone is appropriate for you or your household, particularly if you have risk factors for opioid overdose.

What should I do if someone overdoses on codeine?

Call 911 immediately. If naloxone is available, administer it according to its instructions while emergency medical assistance is being obtained.

Authoritative External References

FDA — Codeine Information
information

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