Codeine may be habit forming. Take codeine exactly as directed. Do not take more or less of it, take it more often, stop taking it suddenly, or take it in a different way than directed by your doctor. Tell your doctor if you or anyone in your family drinks or has ever drunk large amounts of alcohol, uses or has ever used street drugs, or has overused prescription medications, or has had an overdose, or if you have or have ever had depression or another mental illness.
Codeine may cause serious or life-threatening breathing problems, especially during the first 24 to 72 hours of your treatment and any time your dose is increased. If you experience any of the following symptoms, call your doctor immediately or get emergency medical treatment: slowed breathing, long pauses between breaths, or shortness of breath.
Codeine may harm or cause death to other people who take your medication, especially children. Store codeine in a safe place so that no one else can take it accidentally or on purpose.
Taking certain medications, drinking alcohol, or using street drugs during your treatment with codeine may increase the risk that you will experience breathing problems or other serious, life-threatening breathing problems, sedation, or coma. Tell your doctor and pharmacist what other prescription and nonprescription medications, vitamins, nutritional supplements, and herbal products you are taking or plan to take. Your doctor may need to change the dosages of your medications and will monitor you carefully.
Tell your doctor if you are pregnant or plan to become pregnant. If you take codeine regularly during your pregnancy, your baby may experience life-threatening withdrawal symptoms after birth.
Your doctor or pharmacist will give you the Medication Guide. Read the information carefully and ask your doctor or pharmacist if you have any questions. You can also visit https://www.fda.gov/Drugs/DrugSafety/ucm085729.htm to obtain the Medication Guide.Talk to your doctor about the risks of taking codeine.
Why is this medicine prescribed?
Codeine is used to relieve pain. It is also used to relieve cough. Codeine belongs to a class of medications called opiate (narcotic) analgesics and to a class of medications called antitussives. When codeine is used to treat pain, it works by changing the way the brain and nervous system respond to pain. When codeine is used to reduce coughing, it works by decreasing the activity in the part of the brain that causes coughing.
Codeine is also available in combination with acetaminophen and aspirin, and as an ingredient in many cough and cold medications. This monograph only includes information about the use of codeine. If you are taking a codeine combination product, be sure to read information about all the ingredients in the product you are taking and ask your doctor or pharmacist for more information.
Are there other uses for this medicine?
This medication is sometimes prescribed for other uses; ask your doctor or pharmacist for more information.
How should this medicine be used?
Codeine comes as an immediate-release tablet, an extended-release tablet, a solution (liquid), and syrup to take by mouth. Take every 4 hours as needed for pain. Take codeine solution or syrup every 4 to 6 hours as needed to relieve cough. Take codeine extended-release tablets every 12 hours as needed to relieve cough.
If you are taking codeine to relieve pain, your doctor may adjust your dose during your treatment, depending on how well your pain is controlled and on the side effects that you experience. Talk to your doctor about how you are feeling during your treatment with codeine. Tell your doctor if you feel that your pain is not controlled or if your pain increases, becomes worse, or if you have new pain or an increased sensitivity to pain during your treatment with codeine. Do not take more of it or take it more often than prescribed by your doctor.
Talk to your doctor or pharmacist about access to rescue medicines, naloxone or nalmefene, while taking codeine. Rescue medications can reverse the life-threatening effects of an opioid overdose and are available over the counter or with a prescription. Make sure that you and your family members and people usually around you know how to recognize an overdose, how to use naloxone or nalmefene, and what to do until emergency medical help arrives. Your doctor or pharmacist will show you and others how to use it. If symptoms of an overdose occur, they should give the first dose of naloxone, call 911 immediately, and stay with you and watch you closely until emergency medical help arrives. If your symptoms return, the person should give you another dose of the rescue medication. Additional doses may be given every 2 to 3 minutes, if symptoms return before medical help arrives.
If you have taken codeine for several weeks or longer, do not stop taking the medication without talking to your doctor. Your doctor may decrease your dose gradually. If you suddenly stop taking codeine, you may experience withdrawal symptoms such as restlessness, widened pupils (black circles in the center of the eyes), teary eyes, irritability, anxiety, runny nose, difficulty falling asleep or staying asleep, yawning, sweating, fast breathing, fast heartbeat, chills, hair on your arms standing on end, nausea, loss of appetite, vomiting, diarrhea, stomach cramps, muscle aches, or backache.
If you are taking codeine oral solution or syrup, do not use a household spoon to measure your dose. Use the measuring cup or spoon that came with the medication or use a spoon that is made especially for measuring medication. Ask your pharmacist if you have any question about how much medication you should take or how to use the dosing cup or syringe.
What special precautions should I follow?
Before taking codeine,
- tell your doctor and pharmacist if you are allergic to codeine, any other medications, or any of the ingredients in the codeine product you plan to take. Ask your doctor or pharmacist for a list of the ingredients.
- some medications should not be taken with codeine. Make sure you have discussed any medications you are currently taking or plan to take before starting codeine with your doctor and pharmacist. Before starting, stopping, or changing any medications while taking codeine, please get the advice of your doctor or pharmacist.
- tell your doctor or pharmacist if you are taking the following medications or if you have stopped taking them within the past 2 weeks: isocarboxazid, linezolid, methylene blue, phenelzine, selegiline, or tranylcypromine.
- the following nonprescription or herbal products may interact with codeine: St. John's wort and tryptophan. Be sure to let your doctor and pharmacist know that you are taking these medications before you start taking codeine. Do not start these medications while taking codeine without discussing it with your healthcare provider.
- tell your doctor if you have or have ever had a brain tumor, or any condition that increases the amount of pressure in your brain; seizures; or thyroid, pancreatic, gallbladder, heart, liver, or kidney disease.
- you should know that this medication may decrease fertility in men and women. Talk to your doctor about the risks of taking codeine.
- tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking codeine, call your doctor.
- you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
- you should know that codeine may cause dizziness, lightheadedness, and fainting when you get up too quickly from a lying position. This is more common when you first start taking codeine. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.
- you should know that codeine may cause constipation. Talk to your doctor about changing your diet and using other medications to treat or prevent constipation.
- you should know to not drink alcoholic beverages while you are taking codeine. Alcohol can make the side effects from codeine worse.
What special dietary instructions should I follow?
Unless your doctor tells you otherwise, continue your normal diet.
What should I do if I forget to take a dose?
Codeine is usually taken as needed. If you miss a dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
What should I do in case of overdose?
In case of overdose, call the poison control helpline at 1-800-222-1222. Information is also available online at https://www.poisonhelp.org/help . If the victim has collapsed, had a seizure, has trouble breathing, or can't be awakened, immediately call emergency services at 911.
Symptoms of overdose may include the following:
- difficulty breathing, slow or shallow breathing
- unable to respond or wake up
- limp or weak muscles
- cold and clammy skin
- increase or decrease in pupil (dark circle in the eye) size
- slow heartbeat
What side effects can this medicine cause?
Codeine may cause side effects. Tell your doctor if any of these symptoms or those in the SPECIAL PRECAUTIONS section are severe or do not go away:
- nausea, vomiting
- sweating
- decreased sexual desire, inability to get or keep an erection
Some side effects can be serious. If you experience any of the following symptoms or those listed in the IMPORTANT WARNINGS section, stop taking codeine and call your doctor immediately or get emergency medical attention:
- agitation, hallucinations (seeing things or hearing voices that do not exist), fever, sweating, confusion, fast heartbeat, shivering, severe muscle stiffness or twitching, loss of coordination, nausea, vomiting, or diarrhea
- nausea, vomiting, loss of appetite, weakness, or dizziness
- chest pain, changes in heartbeat
- rash; hives; itching; nausea; vomiting; hoarseness; difficulty breathing or swallowing; or swelling of the eyes, face, lips, mouth, tongue or throat
- seizures
- extreme drowsiness
- new pain or pain from touch or doing ordinary tasks such as combing your hair
- difficulty swallowing, regurgitation (bringing up swallowed food into throat and mouth), pain in the chest area
- unusual snoring or long pauses during breaths during sleep
Codeine may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.
If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration's (FDA) MedWatch Adverse Event Reporting program online ( https://www.fda.gov/Safety/MedWatch ) or by phone ( 1-800-332-1088).What should I know about storage and disposal of this medication?
Keep this medication in the container it came in, tightly closed, and out of reach of children, and in a location that is not easily accessible by others, including visitors to the home. Store it at room temperature and away from excess heat and moisture (not in the bathroom).
Keep all medication out of sight and reach of children as many containers are not child-resistant. Always lock safety caps. Place the medication in a safe location – one that is up and away and out of their sight and reach. https://www.upandaway.org Dispose of unneeded medications in a way so that pets, children, and other people cannot take them. Do not flush this medication down the toilet. Use a medicine take-back program. Talk to your pharmacist about take-back programs in your community. Visit the FDA's Safe Disposal of Medicines website https://goo.gl/c4Rm4p for more information.What other information should I know?
Keep all appointments with your doctor.
Before having any laboratory test, tell your doctor and the laboratory personnel that you are taking codeine.
Do not let anyone else use your medication, even if he or she has the same symptoms that you have. Selling or giving away this medication may cause death or harm to others and is illegal. Your prescription might not be refillable. Ask your pharmacist any questions you have about refilling your prescription.
Keep a written list of all of the prescription and nonprescription (over-the-counter) medicines, vitamins, minerals, and dietary supplements you are taking. Bring this list with you each time you visit a doctor or if you are admitted to the hospital. You should carry the list with you in case of emergencies.