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Brand Name

ratio-Codeine

Common Name

codeine

How does this medication work? What will it do for me?

Codeine belongs to the class of medications called narcotic analgesics ("analgesic" means "pain reliever"). It is used to relieve moderate-to-severe pain. It works by blocking pain signals that are sent out by the brain to various areas of the body.

Codeine is also used to control coughing that is not controlled by non-narcotic cough suppressants. It works by acting in the brain to dull the cough reflex.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. As well, some forms of this medication may not be used for all of the conditions discussed here. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

How should I use this medication?

Pain relief: The recommended adult dose of codeine for pain relief is 15 mg to 60 mg every 4 to 6 hours as required, not to exceed 360 mg in one day. For children over one year of age, the recommended dose for pain relief is based on body weight.

Cough: The recommended adult dose of codeine as a cough suppressant is 5 mg to 20 mg every 4 to 8 hours as needed. The dose for children varies according to age, and codeine as a cough suppressant is not recommended for children less than two years of age.

Many things can affect the dose of a medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one. If you are not sure what to do after missing a dose, contact your doctor or pharmacist for advice.

Store this medication at room temperature, protect it from light and moisture, and keep it out of the reach of children

What form(s) does this medication come in?

Tablets

15 mg
Each round, white tablet, imprinted with "TEC 15" on one side and plain on the other side contains codeine phosphate 15 mg. Nonmedicinal ingredients: colloidal silicon dioxide, lactose, magnesium stearate, microcrystalline cellulose, and stearic acid. This medication does not contain gluten, parabens, sodium, or sulfites

30 mg
Each round, white tablet imprinted with "TEC 30" on one side and plain on the other side contains codeine phosphate 30 mg. Nonmedicinal ingredients: colloidal silicon dioxide, lactose, magnesium stearate, microcrystalline cellulose, and stearic acid. This medication does not contain gluten, parabens, sodium, or sulfites.

Syrup

Each mL of clear, colourless, syrupy liquid contains codeine phosphate 5 mg. Nonmedicinal ingredients: 0.61% w/v alcohol, purified water, sodium benzoate, sodium bisulfite, and sucrose.

Some medications may have other generic brands available. Always ask your doctor or pharmacist about the safety of switching between brands of the same medication.

Who should NOT take this medication?

This medication should not to be used by anyone who:

• is allergic to codeine or to any of the ingredients of the medication
• is allergic to any morphine-type medications
• is a premature infant or is pregnant and expecting delivery of a premature infant
• is having difficulty breathing or has lung disease
• experiences easily triggered seizures or has a poorly controlled seizure disorder
• has a head injury or increased pressure inside the head or spinal cord
• has diarrhea caused by poisoning, until the toxic substance is cleared from the gastrointestinal tract

What side effects are possible with this medication?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• blurred or double vision, or other changes in vision
• constipation
• dizziness, light-headedness, or feeling faint
• drowsiness
• dry mouth
• headache
• loss of appetite
• nausea or vomiting
• unusual tiredness or weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not check with your doctor or seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• depression or other mood or mental changes
• fast, slow, or pounding heartbeat
• feelings of unreality
• hallucinations (seeing, hearing, or feeling things that are not there)
• hives, itching, or skin rash
• increased sweating
• irregular breathing
• redness or flushing of face
• ringing or buzzing in the ears
• shortness of breath, wheezing, or troubled breathing
• swelling of face
• trembling or uncontrolled muscle movements
• unusual excitement or restlessness (especially in children)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• cold, clammy skin
• confusion
• low blood pressure
• pinpoint pupils of eyes
• seizures
• severe dizziness severe drowsiness
• severe nervousness or restlessness
• severe weakness
• signs of an allergic reaction (hives; difficulty breathing; swelling of the face, tongue, or throat)
• slow heartbeat
• slow or troubled breathing

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

Are there any other precautions or warnings for this medication?

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Dependence: Codeine may be habit-forming. As with other narcotic medications, psychological dependence, physical dependence, and tolerance may develop. The addicting potential of the medication appears to be about the same as for morphine. Talk to your doctor if you have any concerns about taking this medication.

Drowsiness/reduced alertness: Codeine may cause drowsiness. Do not drive, operate machinery, or perform any potentially hazardous tasks until you have made sure that this medication does not make you drowsy.

Inflammatory bowel disease: People with conditions affecting the digestive system such as inflammatory bowel disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Kidney disease: People with kidney disease or reduced kidney function should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Liver disease: People with liver disease should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Lung disease: People with lung disease or breathing problems should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Seizure disorders: People with seizure disorders or a history of seizures should discuss with their doctor how this medication may affect their medical condition, how their medical condition may affect the dosing and effectiveness of this medication, and whether any special monitoring is needed.

Withdrawal effects: As with other narcotic medications, codeine can produce physical dependence, with or without psychological dependence if it is taken regularly for a period of time. If this medication is stopped suddenly, it may produce withdrawal symptoms such as body aches, diarrhea, decreased appetite, runny nose, sneezing, tremors, shivering nausea, sweating, yawning, and weakness. Talk to your doctor before stopping this medication if you have been taking it routinely.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication may pass into breast milk. If you are a breast-feeding mother and are taking codeine, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Seniors: Seniors are likely to experience side effects with codeine when taken at adult doses You may need to use a lower dose to avoid side effects of this medication.

What other drugs could interact with this medication?

There may be an interaction between codeine and any of the following:

alcohol amphetamines anesthetics anticholinergic medications (e.g., atropine, scopolamine) antifungal medications (e.g., fluconazole, itraconazole, ketoconazole) antihistamines that cause drowsiness (e.g., chlorpheniramine, diphenhydramine) barbiturates (e.g., phenobarbital, butalbital) benzodiazepines (e.g., diazepam, lorazepam, oxazepam) beta-blockers (e.g., atenolol, propranolol) butorphanol carbamazepine chloral hydrate cimetidine erythromycin isoniazid

monoamine oxidase inhibitors (MAOIs; e.g., phenelzine, tranylcypromine) methocarbamol nalbuphine naltrexone other narcotic pain relievers (e.g., fentanyl, hydrocodone, morphine) pentazocine phenothiazines (e.g., chlorpromazine, prochlorperazine) phenytoin quinidine rifampin SSRIs (e.g., fluvoxamine, paroxetine, sertraline) " selegiline " thiopental " tramadol " tricyclic antidepressants (e.g., amitriptyline, desipramine, nortriptyline) " warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Disclaimer

The information within this website is for Canadian audiences only. This content is for informational purposes only. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects. It should not be construed to indicate that the use of a particular drug is safe, appropriate or effective for you. It should not be relied upon or interpreted as a recommendation for any specific treatment plan, product or course of action. The information on the site is not intended as a substitute of any kind for professional medical advice, diagnosis or treatment. Speak to your healthcare professional before taking any product, changing your lifestyle, or beginning or discontinuing any course of treatment. If you suspect that you are ill or may have a medical emergency, contact a physician, a health professional or call 911 immediately.