What is codeine?
Codeine Phosphate is an opioid pain medication. An opioid is sometimes called a narcotic.
Codeine Phosphate is used to treat mild to moderately severe pain.
Codeine Phosphate may also be used for purposes not listed in this medication guide.
You should not use codeine if you are allergic to it, or if you have an uncontrolled breathing disorder, a bowel obstruction called paralytic ileus, or frequent asthma attacks or hyperventilation.
Codeine can slow or stop your breathing, and may be habit-forming. Use only your prescribed dose. Never share codeine with another person.
MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription.
Medicines that contain Codeine Phosphate should not be given to a child just after surgery to remove the tonsils or adenoids.
Get emergency medical help if a child taking this medication has breathing problems, blue lips, or severe drowsiness, or if you cannot wake the child up from sleep.
Before taking this medicine
You should not use codeine if you are allergic to it, or if you have:
- untreated or uncontrolled asthma or other breathing disorder;
- a bowel obstruction called paralytic ileus; or
- frequent asthma attacks or hyperventilation.
Medicines that contain codeine should not be given to a child just after surgery to remove the tonsils or adenoids.
In some people, codeine breaks down rapidly in the liver and reaches higher than normal levels in the body. This can cause dangerously slow breathing and may cause death, especially in a child.
Some medicines can interact with Codeine Phosphate and cause a serious condition called serotonin syndrome. Be sure your doctor knows if you also take medicine for depression, mental illness, Parkinson’s disease, migraine headaches, serious infections, or prevention of nausea and vomiting. Ask your doctor before making any changes in how or when you take your medications.
To make sure this medicine is safe for you, tell your doctor if you have:
- liver disease;
- asthma, COPD, sleep apnea, or other breathing disorders;
- abnormal curvature of the spine that affects breathing;
- kidney disease;
- a history of head injury or brain tumor;
- low blood pressure;
- blockage in your digestive tract (stomach or intestines);
- a gallbladder or pancreas disorder;
- underactive thyroid;
- Addison’s disease or other adrenal gland disorder;
- enlarged prostate, urination problems;
- mental illness;
- a history of drug or alcohol addiction; or
- if you use a sedative like Valium (diazepam, alprazolam, lorazepam, Ativan, Klonopin, Restoril, Tranxene, Versed, Xanax, and others).
It is not known whether this medicine will harm an unborn baby. If you use Codeine Phosphate while you are pregnant, your baby could become dependent on the drug. This can cause life-threatening withdrawal symptoms in the baby after it is born. Babies born dependent on habit-forming medicine may need medical treatment for several weeks. Tell your doctor if you are pregnant or plan to become pregnant.
Codeine Phosphate can pass into breast milk and may harm a nursing baby. The use of Codeine Phosphate by some nursing mothers may lead to life-threatening side effects in the baby. Do not breast-feed while taking this medicine.
Older adults may be more sensitive to the effects of this medicine.
How should I take codeine?
Follow all directions on your prescription label. Codeine Phosphate can slow or stop your breathing. Never use this medicine in larger amounts, or for longer than prescribed. Tell your doctor if the medicine seems to stop working as well in relieving your pain.
Codeine Phosphate may be habit-forming, even at regular doses. Never share this medicine with another person, especially someone with a history of drug abuse or addiction. MISUSE OF NARCOTIC MEDICINE CAN CAUSE ADDICTION, OVERDOSE, OR DEATH, especially in a child or other person using the medicine without a prescription. Selling or giving away Codeine Phosphate is against the law.
Take Codeine Phosphate with food or milk if it upsets your stomach.
Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one.
Drink 6 to 8 full glasses of water daily to help prevent constipation while you are taking Codeine Phosphate. Do not use a stool softener (laxative) without first asking your doctor.
Do not stop using codeine suddenly after long-term use, or you could have unpleasant withdrawal symptoms. Ask your doctor how to safely stop using this medicine.
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. Disposal of medicines by flushing is recommended to reduce the danger of accidental overdose causing death. This advice applies to a very small number of medicines only. The FDA, working with the manufacturer, has determined this method to be the most appropriate route of disposal and presents the least risk to human safety.
What happens if I miss a dose?
Since codeine is used for pain, you are not likely to miss a dose. Skip any missed dose if it is almost time for your next scheduled dose. Do not use 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. A codeine overdose can be fatal, especially in a child or other person using the medicine without a prescription. Overdose symptoms may include slow breathing and heart rate, severe drowsiness, muscle weakness, cold and clammy skin, pinpoint pupils, and fainting.
What should I avoid while taking codeine?
Do not drink alcohol. Dangerous side effects or death can occur when alcohol is combined with codeine.
Codeine may impair your thinking or reactions. Avoid driving or operating machinery until you know how this medicine will affect you. Dizziness or severe drowsiness can cause falls or other accidents.
Codeine side effects
Get emergency medical help if you have any signs of an allergic reaction to codeine: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.
Like other narcotic medicines, codeine can slow your breathing. Death may occur if breathing becomes too weak.
Seek emergency medical attention if a child taking this medication has any of the following life-threatening side effects: noisy breathing, sighing, slow breathing with long pauses between breaths; being unusually sleepy or hard to wake up; blue colored lips.
Call your doctor at once if you have:
- 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);
- problems with urination;
- infertility, missed menstrual periods;
- impotence, sexual problems, loss of interest in sex; or
- low cortisol levels – nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness.
Seek medical attention right away if you have symptoms of serotonin syndrome, such as: agitation, hallucinations, fever, sweating, shivering, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, vomiting, or diarrhea.
Common codeine side effects include:
- feeling dizzy or drowsy;
- nausea, vomiting, stomach pain;
- 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 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.
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 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.
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 to 6 years: 2.5 to 5 mg orally every 4 to 6 hours
Maximum 30 mg/day
6 to 12 years: 5 to 10 mg orally every 4 to 6 hours
Maximum 60 mg/day
Usual Pediatric Dose for Pain:
1 year or greater: 0.5 mg/kg or 15 mg/m2 orally, IM, or subcutaneously every 4 to 6 hours as needed