Codeine

Sounds like 'KOE-deen'

Easy-to-read medicine information about codeine – what is it, how to take codeine safely and possible side effects.

Type of medicine Also called
  • Belongs to a group of medicines known as analgesics (pain killers)
  • Opioid pain reliever 
  • Codeine Phosphate®
  • Panadeine
  • Panadeine Extra
  • Panadeine Plus 
  • Nurofen Plus®
  • Panafen Plus®  

What is codeine?

Codeine is commonly used for the short-term pain relief such as after an operation or a serious injury, or for migraine headaches.  It belongs to a group of pain relievers called opioids and is closely related to morphine. Codeine can also be used to treat cough and diarrhoea. Codeine is commonly found in combination with other ingredients in pain relievers which you can buy without a prescription.
Examples of pain relievers that contain codeine:

  • codeine + paracetamol: Panadeine®, Panadeine Extra®, Panadeine Plus® 
  • codeine + ibuprofen: Nurofen Plus®, Panafen Plus®  

Tell your doctor or pharmacist if you are already taking these.

Dose

  • The dose of codeine will be different for different people. 
  • Always take your codeine exactly as your doctor has told you. The pharmacy label on your medicine will tell you how much codeine to take, how often to take it, and any special instructions.

How to take codeine

  • You can take codeine with or without food.
  • Stop taking codeine if your symptoms are relieved. 
  • Limit or avoid drinking alcohol while your are taking codeine. Combining codeine with alcohol can make you more sleepy, drowsy or dizzy.
  • If you forget to take your dose, take it as soon as you remember that day. But, if it is nearly time for your next dose, just take the next dose at the right time. Do not take double the amount.

Precautions — before starting codeine

  • Are you pregnant or breastfeeding?
  • Do you have problems with your liver or your kidneys?
  • Do you have problems with your prostate or any difficulties passing urine?
  • Do you have any breathing problems, such as asthma or chronic obstructive pulmonary disease (COPD)?
  • Have you had a recent head injury?
  • Do you suffer from constipation - have been constipated for more than a week or have an inflammatory bowel problem?
  • Have you ever been dependent on drugs or alcohol?

If so, it’s important that you tell your doctor or pharmacist before you start codeine. Sometimes a medicine isn’t suitable for a person with certain conditions, or it can only be used with extra care.

Possible side effects

Like all medicines, codeine can cause side effects, although not everyone gets them. Often side effects improve as your body gets used to the new medicine.

Addiction

Addiction is an excessive craving. If you are addicted to codeine, it means you are not able to control your use of it. It is unusual for people who are prescribed codeine for short periods of time to become addicted to it. However, some people are more likely to develop addiction than others and seem to be very sensitive to the cravings. People who are addicted can still have cravings for codeine even after they have reduced them slowly and are no longer dependent on them. You may be at risk for addiction if you have mental health problems such as depression or a history of substance abuse, including alcohol and recreational drugs.

Other side effects

Side effects What should I do?
  • Feeling sleepy, dizzy or tired
  • Be careful when driving or using tools until you know how this medicine affects you.
  • Feeling sick or vomiting
  • Try taking codeine after meals.
  • Tell your doctor if this is troublesome
  • Constipation
  • Eat a diet rich in fibre and drink plenty of water.
  • Tell your doctor if troublesome.
  • Headache, dry mouth, altered vision, skin rash and itching
  • These are quite common when you first start taking codeine, and usually go away with time.
  • Tell your doctor if troublesome.
  • Breathing difficulties, changes to your heartbeat
  • Tell your doctor immediately or ring HealthLine

Interactions

  • Codeine may interact with a few medications and herbal supplements, so check with your doctor or pharmacist before starting codeine or before starting any new medicines..
  • It may interact with medicines available without a prescription such as:
    • cough suppressants (such as Benadryl Dry Forte®, Duro-Tuss®)
    • sedating antihistamines (such as Phenergan®)

Learn more

Codeine SafeRx, Waitemata DHB
Codeine Phosphate Medsafe Consumer Information
Codeine New Zealand Formulary Patient Information

References

  1. Codeine New Zealand Formulary
  2. Opioid analgesics New Zealand Formulary
  3. Helping patients cope with chronic non-malignant pain: it’s not about opioids BPAC, 2014
  4. Identifying and managing addiction to opioids  BPAC, 2014
Credits: Sandra Ponen, Pharmacist. Reviewed By: Dr J Bycroft. Health Navigator NZ Last reviewed: 16 Jan 2018