WARNING

Codeine, like other opioids, carries several risks, including:

• Addiction: Codeine can be habit-forming, leading to physical and psychological dependence, especially with prolonged use or misuse.
• Respiratory Depression: High doses of codeine can slow breathing to dangerous levels, potentially leading to respiratory failure and death, especially when combined with other depressants like alcohol or benzodiazepines.
• Overdose: Taking too much codeine can cause overdose symptoms such as extreme drowsiness, confusion, shallow breathing, cold and clammy skin, weak pulse, and even coma or death.
• Tolerance and Dependence: Over time, the body may develop a tolerance to codeine, requiring higher doses to achieve the same effects. This can lead to a cycle of increased use and dependence.
• Withdrawal Symptoms: When someone who is physically dependent on codeine stops using it suddenly, they may experience withdrawal symptoms such as restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes.
• Drug Interactions: Codeine can interact with other medications, particularly other central nervous system depressants, increasing the risk of respiratory depression and other adverse effects.
• Adverse Effects: Common side effects of codeine include drowsiness, dizziness, nausea, vomiting, constipation, and headache. Long-term use can also lead to liver and kidney damage.

It’s crucial to use codeine only as prescribed by a healthcare professional, in the recommended dosage and duration, and to be aware of the potential risks and side effects.

Why is this medication prescribed?

Codeine is a medication primarily prescribed for pain relief and cough suppression. Here’s how it’s typically used:

• Pain Relief: Codeine is often prescribed for mild to moderate pain relief, such as that from dental procedures, injuries, or conditions like arthritis.
• Cough Suppression: Codeine can also be used as a cough suppressant, particularly in cases of persistent coughing, such as that associated with respiratory infections or certain lung conditions.

How should this medicine be used?

How codeine should be used:

• Dosage: Codeine is typically taken orally in the form of tablets, capsules, or liquid solution. The dosage prescribed will depend on various factors including the severity of pain or cough, the individual’s medical condition, and their response to the medication.
• Frequency: It’s important to take codeine exactly as prescribed by a healthcare professional. This usually means taking it every 4 to 6 hours as needed for pain relief, or as directed for cough suppression. It’s essential not to exceed the prescribed dosage or frequency.
• Duration: Codeine should be used for the shortest duration possible to relieve symptoms effectively. Prolonged or excessive use can lead to tolerance, dependence, and other adverse effects.
• Precautions: It’s crucial to follow all instructions provided by the prescribing healthcare professional. Codeine should not be taken with alcohol or other central nervous system depressants, as this can increase the risk of respiratory depression and other serious side effects. Additionally, driving or operating machinery should be avoided while taking codeine due to its potential to cause drowsiness and impair cognitive function.
• Discontinuation: If codeine is being used for pain relief, it should be tapered off gradually to avoid withdrawal symptoms. Suddenly stopping codeine after prolonged use can lead to withdrawal symptoms such as restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes.

As with any medication, it’s essential to discuss potential risks, benefits, and proper usage with a healthcare professional before starting treatment with codeine.

Other uses for this medicine

• Diarrhea: In some cases, codeine may be used to treat severe diarrhea, as it slows down intestinal motility.
• Migraine: Codeine may be used in combination with other medications to treat severe migraine headaches when other treatments have failed.
• Severe Anxiety: In rare cases, codeine may be used as an adjunctive treatment for severe anxiety disorders, although this is not common practice due to the risk of dependence and other adverse effects.

What special precautions should I follow?

Special precautions to follow when using codeine include:

• Medical History: Inform your healthcare provider about any medical conditions you have, especially if you have a history of respiratory problems, liver or kidney disease, substance abuse, mental health disorders, or if you are pregnant or breastfeeding.
• Allergies: Let your healthcare provider know if you have any allergies, especially to opioids or other medications.
• Other Medications: Inform your healthcare provider about all other medications you are taking, including prescription drugs, over-the-counter medications, vitamins, and herbal supplements. Codeine can interact with certain medications, particularly other central nervous system depressants, increasing the risk of respiratory depression and other adverse effects.
• Pregnancy and Breastfeeding: Codeine should be used with caution during pregnancy, especially in the third trimester, as it can cause respiratory depression and withdrawal symptoms in newborns. It can also pass into breast milk and may harm a nursing infant.
• Driving and Machinery: Codeine can cause drowsiness, dizziness, and impaired cognitive function. Avoid driving, operating machinery, or engaging in any activity that requires mental alertness until you know how codeine affects you.
• Alcohol: Avoid alcohol while taking codeine, as it can increase the risk of side effects, including respiratory depression and sedation.
• Tolerance and Dependence: Codeine can be habit-forming, leading to physical and psychological dependence with prolonged use. Use only as prescribed and avoid increasing the dosage without consulting your healthcare provider.

Always follow your healthcare provider’s instructions and take codeine exactly as prescribed to minimize the risk of adverse effects and dependence. If you have any questions or concerns about using codeine, don’t hesitate to discuss them with your healthcare provider.

What special dietary instructions should I follow?

Special dietary instructions for codeine are generally not necessary. However, it’s essential to stay hydrated and maintain a balanced diet while taking any medication. Be sure to follow any dietary recommendations provided by your healthcare provider based on your individual health needs.

What should I do if I forget a dose?

If you forget to take a dose of codeine, take it as soon as you remember, unless it is almost time for your next dose. In that case, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to catch up. If you are unsure about what to do, consult your healthcare provider or pharmacist for guidance. It’s essential to maintain consistent dosing to achieve optimal pain relief or symptom management.

What side effects can this medication cause?

Codeine, like other opioids, can cause various side effects. Common side effects include:

• Drowsiness: Codeine can cause drowsiness, which may impair your ability to concentrate or perform tasks requiring mental alertness, such as driving.
• Constipation: Opioids like codeine can slow down bowel movements, leading to constipation. It’s important to maintain adequate hydration and dietary fiber intake to help prevent or alleviate this side effect.
• Nausea and Vomiting: Some individuals may experience nausea or vomiting when taking codeine, especially when first starting treatment or at higher doses.
• Dizziness: Codeine can cause dizziness or lightheadedness, particularly when standing up quickly from a sitting or lying position.
• Dry Mouth: Opioids may cause dry mouth, which can contribute to dental issues such as tooth decay and gum disease.
• Sedation: Codeine can induce a state of relaxation or sedation, which may be desirable for managing pain but can also interfere with daily activities.
• Itching: Some individuals may experience itching or a rash when taking codeine.
• Respiratory Depression: In high doses or when combined with other central nervous system depressants like alcohol or benzodiazepines, codeine can suppress breathing, leading to respiratory depression, which can be life-threatening.
• Tolerance and Dependence: Prolonged use of codeine can lead to tolerance, meaning higher doses are needed to achieve the same effect, and dependence, where the body becomes reliant on the drug to function normally.
• Withdrawal Symptoms: When someone who is physically dependent on codeine stops taking it suddenly, they may experience withdrawal symptoms such as restlessness, muscle and bone pain, insomnia, diarrhea, vomiting, and cold flashes.

It’s essential to be aware of these potential side effects and to use codeine only as prescribed by a healthcare professional. If you experience any concerning side effects while taking codeine, be sure to inform your healthcare provider promptly. They can provide guidance on managing side effects or adjusting your treatment plan if necessary.

What should I know about storage and disposal of this medication?

When it comes to storage and disposal of codeine:

• Storage: Keep codeine in its original container, tightly closed, and out of reach of children and pets. Store it at room temperature away from light and moisture. Avoid storing it in the bathroom, where moisture levels can fluctuate.
• Disposal: Dispose of unused or expired codeine properly to prevent accidental ingestion or misuse. Many pharmacies and local government agencies offer drug take-back programs for safe disposal. If a take-back program is not available, you can dispose of codeine by mixing it with undesirable substances like coffee grounds or cat litter and sealing it in a plastic bag before throwing it in the trash. Remove any personal information from the prescription label before disposal.

In case of emergency/overdose

• Seek Medical Help: If you suspect an overdose or experience severe symptoms such as difficulty breathing, extreme drowsiness, loss of consciousness, or seizures, call emergency services (such as 911 in the United States) immediately.
• Naloxone: Naloxone is an opioid antagonist that can reverse the effects of opioid overdose, including codeine. It is available as a nasal spray or injection. If you or someone you know is at risk of opioid overdose, it’s advisable to have naloxone readily available and to know how to administer it.
• Follow Medical Instructions: Follow any instructions provided by emergency responders or healthcare professionals. It’s essential to receive prompt medical attention in the event of a codeine overdose to prevent serious complications or death.

What other information should I know?

• Interactions: Codeine can interact with other medications, including certain antidepressants, antihistamines, sedatives, and muscle relaxants. Inform your healthcare provider about all medications you are taking to avoid potentially harmful interactions.
• Allergic Reactions: Seek medical attention immediately if you experience signs of an allergic reaction to codeine, such as rash, itching, swelling of the face, tongue, or throat, severe dizziness, or trouble breathing.
• Medical Alert: Wear a medical alert bracelet or carry a medical alert card indicating that you are taking codeine, especially if you have a history of opioid sensitivity or if you are prescribed opioid pain medications.
• Regular Monitoring: Your healthcare provider may monitor your response to codeine and adjust your dosage or treatment plan as needed. Keep all scheduled appointments and follow up with your healthcare provider regularly.

By following proper storage and disposal procedures, being aware of the signs of overdose, and staying informed about potential interactions and allergic reactions, you can use codeine safely and effectively.