What is codeine?
Codeine is in a group of drugs called narcotic pain medicines.
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 about codeine
Codeine may be habit-forming and should be used only by the person it was prescribed for. Never share codeine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol.
Never take codeine in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Codeine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert. Do not stop using codeine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using codeine.
Before taking codeine
Do not use codeine if you have ever had an allergic reaction to a narcotic medicine (examples include, methadone, morphine, OxyContin, Darvocet, Percocet, Vicodin, Lortab, and many others). You should also not take codeine if you are having an asthma attack or if you have abowel obstruction called paralytic ileus.
Codeine may be habit-forming and should be used only by the person it was prescribed for. Never share codeine with another person, especially someone with a history of drug abuse or addiction. Keep the medication in a place where others cannot get to it.
If you have any of these other conditions, you may need a codeine dose adjustment or special tests:
- asthma, COPD, sleep apnea, or other breathing disorders;
- liver or kidney disease;
- underactive thyroid;
- curvature of the spine;
- a history of head injury or brain tumor;
- epilepsy or other seizure disorder;
- low blood pressure;
- gallbladder disease;
- a pancreas disorder;
- an intestinal disorder;
- Addison's disease or other adrenal gland disorders;
- enlarged prostate, urination problems;
- mental illness; or
- a history of drug or alcohol addiction.
FDA pregnancy category C. It is not known whether codeine will harm an unborn baby. Codeine may cause addiction or withdrawal symptoms in a newborn if the mother takes this medicine during pregnancy. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine. 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 use codeine without telling your doctor if you are breast-feeding a baby.
Older adults may be more sensitive to the effects of this medicine.
How should I take codeine?
Take codeine exactly as prescribed. Never take codeine in larger amounts, or for longer than recommended by your doctor. Follow the directions on your prescription label. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Take this medicine with a full glass of water.
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.
Take codeine with food or milk if it upsets your stomach. Do not stop using codeine suddenly, or you could have unpleasant withdrawal symptoms. Ask your doctor how to avoid withdrawal symptoms when you stop using codeine. 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.
What happens if I miss a dose?
Since this medicine is taken as needed, you may not be on a dosing schedule. If you are taking the medication regularly, take the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not take 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. An overdose of codeine can be fatal.
Overdose symptoms may include extreme drowsiness, pinpoint pupils, confusion, cold and clammy skin, weak pulse, shallow breathing, fainting, or breathing that stops.
What should I avoid while taking codeine?
Do not drink alcohol while you are taking codeine. Dangerous side effects or death can occur when alcohol is combined with a narcotic pain medicine. Check your food and medicine labels to be sure these products do not contain alcohol. Codeine may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be alert.
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. Call your doctor at once if you have a serious side effect such as:
- 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.
Less serious 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.
Codeine Dosing Information
Usual Codeine 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.
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 Codeine 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.
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:
2-6 years: 2.5 to 5 mg orally every 4 to 6 hours.
Maximum 30 mg/day.
6-12 years: 5 to 10 mg orally every 4 to 6 hours.
Maximum 60 mg/day.
Maximum 30 mg/day.
6-12 years: 5 to 10 mg orally every 4 to 6 hours.
Maximum 60 mg/day.
Usual Pediatric Codeine Dose for Pain:
>=1 years: 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?
Do not take codeine with any other narcotic pain medications, sedatives, tranquilizers, sleeping pills, muscle relaxers, or other medicines that can make you sleepy or slow your breathing. Dangerous side effects may result.
Before taking codeine, tell your doctor if you are using pentazocine (Talwin), nalbuphine (Nubain), butorphanol (Stadol), or buprenorphine (Buprenex, Subutex). If you are using any of these drugs, you may not be able to use codeine, or you may need dosage adjustments or special tests during treatment.
This list is not complete and other drugs may interact with codeine. Tell your doctor about all medications you use. This includes prescription, over-the-counter, vitamin, and herbal products. Do not start a new medication without telling your doctor.
