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Codeine Medication: Uses, Dosage, and Side Effects Explained
Summary of Key Points
Codeine is a prescription opioid used to manage mild to moderate pain, suppress cough, and treat diarrhea. It works by altering the way the brain and nervous system perceive pain and by reducing the urge to cough. Since Codeine can be habit-forming, it is essential to use it exactly as prescribed. Always consult your healthcare provider before starting or adjusting your dose.
Names of Codeine Medication
US Brand Name: Tylenol with Codeine (Codeine)
The generic name refers to the active ingredient in the medication, while the brand name is the name given by the manufacturer. The generic name for this medication is listed in parentheses.
Pharmacologic Category of Codeine
Opioid Analgesic
Antitussive (Cough Suppressant)
Codeine Dosage
Codeine is prescribed for various conditions. Below are the typical doses for adults. Always consult your healthcare provider before making any changes to your medication. Our telemedicine providers are available to assist with any questions or concerns.
Codeine for Pain Relief
Initial Dose: 15-60 mg every 4-6 hours as needed
Maximum Dose: 360 mg per day
Codeine for Cough
Initial Dose: 15-30 mg every 4-6 hours as needed
Maximum Dose: 120 mg per day
Codeine for Diarrhea
Initial Dose: 15-60 mg every 4-6 hours as needed
Codeine for Osteoarthritis
Initial Dose: 15-60 mg every 4-6 hours as needed for pain management
Codeine for Cancer Pain
Initial Dose: 15-60 mg every 4-6 hours as needed
Codeine for Migraines
Initial Dose: 15-60 mg every 4-6 hours as needed for pain relief
Codeine for Back Pain
Initial Dose: 15-60 mg every 4-6 hours as needed
Codeine for Postoperative Pain
Initial Dose: 15-60 mg every 4-6 hours as needed
Codeine for Fibromyalgia
Initial Dose: 15-60 mg every 4-6 hours as needed for pain relief
Codeine for Pneumonia (Cough)
Initial Dose: 15-30 mg every 4-6 hours as needed
Maximum Dose: 120 mg per day
Dosage Forms and Strengths of Codeine
Tablet: 15 mg, 30 mg, 60 mg
Oral Solution: 10 mg/5 mL
Oral Suspension: 12 mg/5 mL
Administration Instructions for Codeine
Codeine should be taken by mouth, with or without food. If nausea occurs, taking it with food may help. Always follow your healthcare provider’s instructions. Do not crush or chew the tablets, as this can release the drug all at once, increasing the risk of side effects. If you miss a dose, take it as soon as you remember, but never take two doses at once.
Codeine Side Effects and Adverse Reactions
Like all medications, Codeine can cause side effects. Some are common, while others are rare but more serious. If you experience any side effects, contact your healthcare provider immediately or seek care through our telemedicine services.
Common Codeine Side Effects
Drowsiness: Feeling unusually sleepy or fatigued.
Dizziness: Feeling lightheaded or unsteady.
Constipation: Difficulty passing stools.
Nausea: Feeling queasy or sick to your stomach.
Serious Codeine Side Effects
Respiratory Depression: Slow or shallow breathing, which can be life-threatening.
Severe Allergic Reactions: Rash, itching, swelling, or difficulty breathing.
Dependence and Addiction: Long-term use can lead to physical dependence and addiction.
Contraindications for Codeine Use
A contraindication is a specific situation or condition where a medication should not be used because it may cause harm. If you have any of the following conditions, avoid taking Codeine. Always consult with one of our telemedicine providers before starting or stopping any medication.
Respiratory Depression: Codeine can slow breathing, which can be dangerous for individuals with breathing problems such as asthma or chronic obstructive pulmonary disease (COPD).
Severe Asthma: Codeine can worsen breathing difficulties in people with severe asthma, potentially leading to life-threatening complications.
Paralytic Ileus: This condition causes the intestines to stop moving food through the digestive system. Codeine can exacerbate this by further slowing bowel movements.
Hypersensitivity to Codeine: If you have had an allergic reaction to Codeine or other opioids, avoid taking it. Allergic reactions can range from mild rashes to severe anaphylaxis.
Children under 12 years old: Codeine is unsafe for children under 12 due to the risk of severe breathing problems.
Postoperative Pain in Children: Codeine should not be used to manage pain in children after tonsillectomy or adenoidectomy due to the risk of fatal breathing problems.
Pregnancy (especially third trimester): Codeine can cause withdrawal symptoms in newborns if taken during pregnancy, particularly in the later stages.
Drug-to-Drug Interactions with Codeine
Codeine can interact with other medications, increasing the risk of side effects or reducing its effectiveness. Below are some medications that may interact with Codeine:
Antidepressants: Medications like fluoxetine (Prozac) and sertraline (Zoloft) can increase the risk of serotonin syndrome when combined with Codeine.
Other Opioids: Medications such as oxycodone (OxyContin) and hydrocodone (Vicodin) can increase the risk of overdose when taken with Codeine.
Benzodiazepines: Drugs like diazepam (Valium) and alprazolam (Xanax) can increase the risk of severe drowsiness, respiratory depression, and overdose when combined with Codeine.
Muscle Relaxants: Medications like cyclobenzaprine (Flexeril) can increase drowsiness and the risk of breathing problems when taken with Codeine.
Alcohol: Drinking alcohol while taking Codeine can significantly increase the risk of dangerous side effects such as severe drowsiness, respiratory depression, and overdose.
Codeine in Pregnancy
Is it safe to take Codeine during pregnancy? The use of Codeine, especially in the third trimester, is generally discouraged. Codeine can cross the placenta, potentially leading to neonatal opioid withdrawal syndrome (NOWS) in newborns. In some cases, it may also cause breathing difficulties after birth. If you are pregnant or planning to become pregnant, it’s important to consult your healthcare provider to discuss safer alternatives for managing pain.
Codeine while Breastfeeding
Is it safe to take Codeine while breastfeeding? Codeine is not considered safe during breastfeeding. When metabolized, Codeine phosphate converts into morphine, and in some individuals, this process happens more rapidly, resulting in higher levels of morphine in breast milk. This can lead to serious side effects in infants, such as excessive sleepiness, difficulty feeding, and potentially life-threatening breathing problems. If you are breastfeeding, it’s crucial to discuss safer pain relief options with your healthcare provider.
Estimated Cost of Codeine Medication
The cost of a 30-day supply of Codeine without insurance can vary depending on the dosage and the pharmacy. With a GoodRx coupon, the price for a generic Codeine prescription typically ranges from $10 to $25. Prices may differ, so it’s a good idea to check with your local pharmacy or use online tools like GoodRx to find the best available price.
Possible Alternatives to Codeine
If Codeine is not suitable for you, there are other treatments and lifestyle changes that may help manage your condition. Always consult your healthcare provider before making any changes to your treatment plan. You can also schedule a telemedicine appointment with one of our providers to explore your options.
Pain Management Alternatives
Pain: Non-opioid pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil) may be effective. Additionally, physical therapy and relaxation techniques like yoga or meditation can help manage chronic pain.
Cough Relief Alternatives
Cough: Over-the-counter cough suppressants like dextromethorphan (Robitussin) or natural remedies, such as honey-based treatments, may be safer alternatives for managing a cough, particularly if you are considering Codeine cough syrup.
Diarrhea Treatment Alternatives
Diarrhea: Loperamide (Imodium) is a commonly used over-the-counter medication for diarrhea. Staying hydrated and following a bland diet can also help alleviate symptoms.
Osteoarthritis Pain Relief
Osteoarthritis: Nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen (Aleve) or topical treatments such as capsaicin cream may provide relief. Weight management and low-impact exercises, such as swimming, can also help reduce joint pain.
Cancer Pain Management
Cancer: Pain management for cancer patients may include non-opioid medications, physical therapy, or alternative therapies like acupuncture. Always consult your oncologist for personalized treatment options.
Migraine Relief Options
Migraines: Triptans, such as sumatriptan (Imitrex), or preventive medications like propranolol (Inderal) may be effective. Lifestyle changes, including stress management and avoiding known migraine triggers, can also help reduce the frequency and severity of migraines.
Back Pain Relief
Back Pain: Physical therapy, chiropractic care, and over-the-counter pain relievers like ibuprofen (Advil) may be helpful. Stretching exercises and maintaining good posture can also aid in preventing back pain.
Postoperative Pain Management
Postoperative Pain: Non-opioid pain relievers such as acetaminophen (Tylenol) or NSAIDs may be safer alternatives for managing pain after surgery. Your healthcare provider may also recommend physical therapy to support your recovery.
Fibromyalgia Pain Relief
Fibromyalgia: Medications like pregabalin (Lyrica) or duloxetine (Cymbalta) may help manage fibromyalgia-related pain. Regular exercise and stress management techniques can also improve symptoms and overall well-being.
Pneumonia Treatment
Pneumonia: Antibiotics are the primary treatment for bacterial pneumonia. Over-the-counter medications like acetaminophen (Tylenol) can help manage fever and discomfort. Staying hydrated and getting plenty of rest are also essential for recovery.
Recent Updates on Codeine Research
Recent research has highlighted the risks associated with Codeine use, particularly in children and breastfeeding mothers. Studies show that some individuals metabolize Codeine into morphine more rapidly, leading to higher levels of morphine in the bloodstream. This increases the risk of dangerous side effects, including respiratory depression. As a result, the FDA has issued warnings against using Codeine in children under 12 and breastfeeding mothers. Ongoing research is focused on identifying safer alternatives to Codeine for pain and cough management, with an emphasis on non-opioid medications and therapies.
