WARNING

Codeine is an opioid medication used to treat pain and sometimes coughing. While it can be effective for these purposes, it also poses several risks:

• Addiction: Codeine, like other opioids, can be habit-forming. Regular use can lead to physical dependence and addiction.
• Respiratory Depression: Taking high doses of codeine, especially when combined with other substances like alcohol or benzodiazepines, can slow down breathing to dangerous levels, potentially leading to respiratory depression or even death.
• Constipation: Opioids like codeine can cause constipation, which can be severe in some cases and may require medical intervention.
• Sedation and Drowsiness: Codeine can cause drowsiness and impair cognitive function, which can affect a person’s ability to perform tasks such as driving or operating machinery safely.
• Tolerance and Dependence: Over time, the body may develop a tolerance to codeine, requiring higher doses to achieve the same effect. This can increase the risk of dependence and overdose.
• Withdrawal Symptoms: Abruptly stopping or reducing the dose of codeine after prolonged use can lead to withdrawal symptoms such as restlessness, muscle aches, insomnia, diarrhea, vomiting, and cold flashes.
• Overdose: Taking too much codeine or combining it with other central nervous system depressants can lead to overdose, which can be fatal. Symptoms of overdose include extreme drowsiness, confusion, shallow breathing, pinpoint pupils, and loss of consciousness.
• Drug Interactions: Codeine can interact with other medications, particularly those that also affect the central nervous system, increasing the risk of adverse effects or overdose.

It’s essential to use codeine only as prescribed by a healthcare professional and to be aware of the potential risks and side effects. If you have any concerns about taking codeine or experience any adverse effects, it’s important to seek medical advice promptly.

Why is this medication prescribed?

Codeine is prescribed primarily for its analgesic (pain-relieving) and antitussive (cough-suppressing) properties. Here’s how it’s typically used:

• Pain Relief: Codeine is often prescribed to relieve mild to moderate pain that hasn’t responded to non-opioid pain medications like acetaminophen or ibuprofen. It’s commonly used for conditions such as dental pain, post-surgical pain, and certain types of injuries.
• Cough Suppression: Codeine can be used to suppress a persistent cough that hasn’t responded to other cough suppressants. It works by reducing the activity of the cough reflex in the brain.

How should this medicine be used?

Codeine is available in various forms, including tablets, capsules, and oral solutions. Here are some general guidelines for its use:

• Dosage: The dosage of codeine prescribed will vary depending on the severity of the pain or cough, as well as individual factors such as age, weight, and overall health. It’s essential to follow the dosage instructions provided by your healthcare provider carefully.
• Frequency: Codeine is typically taken every 4 to 6 hours as needed for pain relief or cough suppression. It’s important not to exceed the recommended dosage or frequency of use, as this can increase the risk of adverse effects and dependence.
• Duration: Codeine is usually prescribed for short-term use to relieve acute pain or cough. Prolonged or excessive use can lead to tolerance, dependence, and other risks.
• Administration: Codeine can be taken with or without food, depending on individual preferences and tolerances. It’s important to swallow the tablets or capsules whole with a full glass of water to ensure proper absorption.
• Monitoring: While taking codeine, it’s essential to monitor for any signs of adverse effects, such as excessive drowsiness, difficulty breathing, or changes in mood or behavior. If you experience any concerning symptoms, contact your healthcare provider immediately.
• Discontinuation: When discontinuing codeine after prolonged use, it’s crucial to taper the dosage gradually under the guidance of a healthcare professional to minimize the risk of withdrawal symptoms.

It’s important to use codeine only as prescribed and to avoid sharing it with others, as misuse or abuse can lead to serious health consequences. If you have any questions or concerns about how to use codeine safely and effectively, don’t hesitate to consult your healthcare provider.

Other uses for this medicine

In addition to its primary uses for pain relief and cough suppression, codeine may be prescribed off-label for other purposes, such as:

• Diarrhea: Codeine can be used to treat diarrhea by slowing down intestinal motility. However, this use is less common due to the availability of other more effective medications with fewer side effects.
• Adjunctive Therapy: In some cases, codeine may be prescribed as part of a combination therapy to enhance the effectiveness of other medications.

What special precautions should I follow?

Regarding special precautions for codeine use, here are some important considerations:

• Medical History: Before taking codeine, inform your healthcare provider about any medical conditions you have, especially if you have a history of respiratory problems, liver or kidney disease, head injury, seizures, mental health disorders, or substance abuse.
• Allergies: Tell your doctor if you are allergic to codeine or any other medications, as well as any other allergies you have, such as to foods, dyes, or preservatives.
• Pregnancy and Breastfeeding: Codeine should be used with caution during pregnancy and breastfeeding. It can pass into breast milk and may cause harm to a nursing infant. Consult your doctor before using codeine if you are pregnant or breastfeeding.
• Children and Elderly: Codeine should be used with caution in children and elderly individuals due to an increased risk of respiratory depression and other adverse effects. Dosage adjustments may be necessary based on age and individual factors.
• Drug Interactions: Inform your healthcare provider about all the medications you are taking, including prescription, over-the-counter, and herbal supplements. Codeine can interact with certain medications, such as benzodiazepines, antidepressants, antihistamines, and muscle relaxants, increasing the risk of side effects or overdose.
• Avoid Alcohol: Avoid consuming alcohol while taking codeine, as it can increase the risk of respiratory depression and other adverse effects.
• Driving and Operating Machinery: Codeine can cause drowsiness, dizziness, and impaired judgment. Avoid driving or operating machinery until you know how codeine affects you.
• Proper Use: Take codeine exactly as prescribed by your healthcare provider. Do not exceed the recommended dosage or frequency of use, and do not suddenly stop taking it without consulting your doctor, as this can lead to withdrawal symptoms.

By following these precautions and guidelines, you can use codeine safely and effectively under the supervision of your healthcare provider. If you have any questions or concerns about codeine or its use, don’t hesitate to discuss them with your doctor.

What special dietary instructions should I follow?

Regarding special dietary instructions, there are no specific dietary restrictions associated with codeine use. However, it’s essential to maintain a healthy diet and stay hydrated while taking any medication, including codeine.

What should I do if I forget a dose?

If you forget a dose of codeine, take it as soon as you remember. However, if it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not double the dose to make up for a missed one. If you are unsure about what to do, contact your healthcare provider for advice. It’s essential to maintain consistent dosing to avoid fluctuations in pain relief or cough suppression.

What side effects can this medication cause?

Codeine, like other opioid medications, can cause various side effects, ranging from mild to severe. Common side effects of codeine include:

• Drowsiness: Codeine can cause drowsiness or sedation, which may impair your ability to perform tasks that require alertness, such as driving or operating machinery.
• 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 alleviate this side effect.
• Nausea and Vomiting: Codeine can cause nausea and vomiting, particularly when first starting treatment or at higher doses.
• Dizziness: Some people may experience dizziness or lightheadedness while taking codeine, especially when changing positions quickly.
• Headache: Headaches are a common side effect of codeine use, although they typically diminish with continued use.
• Dry Mouth: Codeine can cause dry mouth, which can be relieved by sipping water or sucking on ice chips.
• Sweating: Excessive sweating, particularly at night, may occur as a side effect of codeine.
• Itching: Some individuals may experience itching or rash while taking codeine. This is more common with higher doses.
• Urinary Retention: In some cases, codeine can cause difficulty urinating or urinary retention.
• Respiratory Depression: In high doses or when combined with other central nervous system depressants, codeine can slow down breathing to dangerous levels, leading to respiratory depression or even death. This is more likely to occur in individuals with pre-existing respiratory conditions.
• Allergic Reactions: Rarely, codeine can cause allergic reactions, including rash, itching, swelling of the face or throat, severe dizziness, or trouble breathing. Seek immediate medical attention if you experience any signs of an allergic reaction.

It’s important to report any side effects to your healthcare provider, especially if they are severe or persistent. Additionally, seek immediate medical attention if you experience symptoms of respiratory depression or any other serious adverse effects while taking codeine.

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

Storage and disposal of codeine:

• Storage: Store codeine tablets, capsules, or oral solutions at room temperature away from moisture, heat, and light. Keep it out of reach of children and pets, preferably in a locked cabinet or medicine box to prevent accidental ingestion.
• Disposal: Dispose of unused or expired codeine properly to prevent misuse or accidental ingestion. Follow any specific disposal instructions provided by your pharmacist or local regulations. Do not flush codeine down the toilet unless instructed to do so.

In case of emergency/overdose

In case of emergency or overdose involving codeine, take the following steps:

• Seek Immediate Medical Attention: If you suspect an overdose or if someone has ingested codeine accidentally, call emergency services (e.g., 911 in the United States) or poison control immediately. Provide as much information as possible about the medication ingested, the dosage, and the person’s condition.
• Monitor Breathing: If the person is experiencing difficulty breathing or shows signs of respiratory depression, such as slow or shallow breathing, monitor their breathing closely. If necessary, perform rescue breathing or CPR until medical help arrives.
• Do Not Delay Treatment: Time is critical in cases of overdose. Do not wait for symptoms to worsen before seeking medical help. Prompt treatment can help prevent serious complications or death.

What other information should I know?

• Avoid Mixing with Alcohol: Mixing codeine with alcohol or other central nervous system depressants can increase the risk of respiratory depression and other adverse effects. Avoid consuming alcohol while taking codeine.
• Potential for Dependence and Addiction: Codeine is an opioid medication with the potential for dependence, tolerance, and addiction, especially with prolonged use or misuse. Use it only as prescribed and follow your doctor’s instructions carefully.
• Avoid Driving or Operating Machinery: Codeine can cause drowsiness, dizziness, and impaired judgment, which can affect your ability to drive or operate machinery safely. Avoid these activities until you know how codeine affects you.
• Medical Follow-Up: Attend all scheduled medical appointments while taking codeine to monitor your response to the medication and any potential side effects. Discuss any concerns or questions with your healthcare provider.

By following these guidelines and being aware of important information about codeine, you can use it safely and effectively under the guidance of your healthcare provider.