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The analysis has shown some worrying trends, with deaths related to codeine use doubling over the study period. Analysis of the characteristics of people who died from codeine-related overdose suggests a complex population of patients who require careful management by prescribers and pharmacists.

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Short PharmGKB tutorial of the CPIC guideline for Codeine and CYP2D6

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Codeine: Codeine, naturally occurring alkaloid of opium, the dried milky exudate of the unripe seed capsule of the poppy Papaver somniferum, that is used in medicine as a cough suppressant and analgesic drug. Codeine exerts its effects by acting on the central nervous system (brain and spinal cord). First

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What is codeine, and how does it work (mechanism of action)?

Codeine is a narcotic pain-reliever and cough suppressant similar to morphine and hydrocodone. Moreover, a small amount of codeine is converted to morphine in the body. The precise mechanism of action of codeine is not known; however, like morphine, codeine binds to receptors in the brain (opioid receptors) that are important for transmitting the sensation of pain throughout the body and brain. Codeine increases tolerance to pain, decreasing discomfort, but the pain still is apparent to the patient. In addition to reducing pain, codeine also causes sedation drowsiness and depresses breathing. Codeine frequently is combined with acetaminophen ( Tylenol) or aspirin for more effective pain relief. The FDA approved codeine in 1950.

Is codeine addictive? Is it a controlled substance?

Codeine is habit forming (addictive). Mental and physical dependence can occur but are unlikely when used for short-term pain relief. Using codeine during pregnancy can cause opioid withdrawal syndrome in the newborn, which may be life-threatening if not treated.

Yes, you need a prescription for codeine. Codeine is a schedule II controlled substance in the US.

What are the side effects of codeine?

The most frequent side effects of codeine include:

Serious side effects of codeine include:

Life-threatening respiratory depression

Severe low blood pressure

Adrenal insufficiency

Accidental ingestion of codeine can result in fatal overdose

The usual adult dose of codeine for pain is 15-60 mg every 4-6 hours as needed. The dose for cough is 10 to 20 mg every 4-6 hours as needed. The maximum dose for treating cough is 120 mg every 24 hours.

Can I drink alcohol with codeine? What other drugs cause interactions with codeine?

Codeine can impair thinking and physical abilities required for driving or operating machinery.

Alcohol and other sedatives such as alprazolam ( Xanax) can produce further brain impairment and even confusion when combined with codeine. Therefore, alcohol and other sedatives should not be used when taking codeine.

Drugs that stimulate and also block opioid receptors (for example, pentazocine) reduce the effect of codeine. Such drugs should not be combined with codeine.

Drugs that block the action of acetylcholine (anticholinergic drugs) increase the occurrence of urinary retention and constipation when combined with codeine.

Monoamine oxidase inhibitors ( MAOIs) class of antidepressants (for example, isocarboxazid [Marplan], phenelzine [Nardil], tranylcypromine [Parnate], selegiline [ Eldepryl], and procarbazine [ Matulane]) significantly increase the action of codeine. Codeine should not be used in patients taking MAOIs or within 14 days of stopping MAOIs.

Is it safe to take codeine if I am pregnant or breastfeeding?

Small amounts of codeine are secreted in breast milk, but the risk of adverse events in the infant is small.

What else should I know about this drug?

What preparations of codeine are available?

Tablets: 15, 30, 60 mg. Solution: 15 mg/5ml (teaspoon). Injection: 15 and 30 mg/ml.

How should I keep codeine stored?

Codeine should be stored between 15 C to 30 C (59 F to 86 F).

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Medically Reviewed on 8/7/2017
Reference: FDA Prescribing Information

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Codeine for Pain: Side Effects, Dosage, Addiction, and Withdrawal

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Codeine is a narcotic (opioid) drug used to relieve mild to moderately severe pain. Since codeine is a narcotic that is addictive and can cause serious side effects such as respiratory or cardiac arrest, and shock, which can lead to death. Dosages of codeine are tailored to each patient's needs.

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FDA Dont Give Children Cough Syrup with Codeine (HD)

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High risk for addiction and dependence. Can cause respiratory distress and death when taken in high doses or when combined with other substances, especially alcohol.

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Parents shouldn't give their children any medications containing the narcotics codeine or tramadol, because they can cause life-threatening breathing problems, the U.S. Food and Drug Administration warned Thursday.

Warning labels on medications with codeine or tramadol will be strengthened to reflect these potential dangers, the FDA said in a statement.

Nursing mothers should also avoid using these drugs, since they can pass unsafe levels of opioids to their babies through their breast milk, the agency said.

Children's bodies tend to process opioids more quickly than most adults, due to their smaller size. That can cause the level of narcotics in their bloodstream to rise too high and too quickly, risking overdose, the agency explained.

Tramadol is a prescription drug that is only approved for adults to treat pain, the agency noted. Codeine products are available by prescription, with some states allowing the drug to be sold over the counter. Codeine is often combined with acetaminophen in prescription pain medicines and cough syrups, the agency said.

The FDA is now warning against children under 12 taking either codeine or tramadol.

Kids under 18 also should not be given tramadol to treat pain following surgery to remove the tonsils or adenoids, the agency said. Codeine labeling already warns against post-surgical use for kids.

Finally, the FDA said that these drugs should not be used in children 12 to 18 who are obese, suffer from obstructive sleep apnea or have a weakened respiratory system, as they can increase the chances of dangerous breathing problems.

Parents should carefully read drug labels to make sure medications don't contain either opioid, the agency stressed. They also can ask their doctor or pharmacist if a specific medication contains codeine or tramadol.

Parents should also discuss alternative pain medications for their kids with their doctors, as well as effective cough and cold remedies that do not contain opioids, the FDA said.

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Don't give kids medicine with codeine or tramadol, FDA warns

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Parents shouldn't give their children any medications containing the narcotics codeine or tramadol, because they can cause life-threatening breathing problems, the U.S. Food and Drug Administration warned Thursday. Warning labels on medications with codeine or tramadol will be strengthened to reflect these potential dangers, the FDA said in a statement.

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Codeine addiction is a widespread, far-reaching problem that spans across ages, ethnicities and socioeconomic backgrounds. Codeine is an addictive drug with potentially dangerous effects high dosages. It essentially acts as a depressant of the central nervous system.

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A Survey on Drug Use and Health indicated about 1.9 million Americans had a prescription painkillers use disorder.Unlike the illicit opioid heroin, doctors frequently prescribe painkillers to people suffering from painful injuries. For example, if a person fractured their arm in a car accident, whether a person begins using illicit or prescribed opioids, they can develop addiction disease. In recent years, medications have been synthesized expressly to treat opioid addiction through drug replacement therapy.

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Rapper Fredo Santana has died in Los Angeles, a family member and the Los Angeles County Coroner's office said Saturday. He was 27. In October, Santana posted on his verified Instagram account that he was being treated for liver and kidney failure.

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You're supposed to take cough syrup with codeine when it's prescribed by a doctor, but teens and young adults are using it to get high. The codeine cocktail craze is making a comeback and now it's more dangerous than ever.