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Codeine is an opioid used to treat pain, and less commonly to suppress coughing, or for diarrhea.[1] It is typically used to treat mild to moderate degrees of pain. Greater benefit may occur codeine is combined with acetaminophen (paracetamol) or a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen.

Codeine is sold over the counter under many different brand names, including:

  • Aceffein
  • Ascodan
  • Algidol
  • Codis 500
  • Copralgir 400
  • Erigon szirup (cough syrup)
  • Feminax
  • Kodamid
  • Kodimagnyl
  • Maxilief
  • Novacetol
  • Natterman Melrosum
  • Nurofen plus
  • Solpadeine migraine
  • Panadeine (extra strength)
  • Paracofdal
  • Parcoten
  • Paderyl
  • Panadeine
  • Migraleve (yellow) Paracodol
  • Sedaspir
  • Syndoland
  • Solpadeinels (max)
  • Solpadeine (plus)
  • Veganin[2]

Codeine variants[edit | edit source]

Codeine is commonly mixed with other drugs, and sold under a different name, e.g.:

  • Co-codaprin is aspirin and codeine[3]
  • Co-codamol is acetaminophen (paracetamol) and codeine[4]

ME/CFS[edit | edit source]

The International Consensus Criteria Primer for physicians and Canadian Consensus Criteria both state that opioids like codeine should only be used for severe pain, and with a management plan in place. No particular opioids are suggested.[5][6]

Opioid crisis[edit | edit source]

Codeine is one of the drugs behind the opioid crisis. Harm from opioids includes:

  • accidental deaths from overdose (taking too much)
  • physical and psychological addiction, which may be diagnosed as opioid use disorder
  • deaths from side effects including breathing difficulties combined with the sedative effects of codeine[7][8]

Opioid drugs including codeine variants and branded products containing codeine have special warnings on the label in many countries, and availability of some products and certain strengths have been restricted, especially over-the-counter availability, for example FDA boxed warnings in the United States.[8]

Side effects[edit | edit source]

The UK's Royal College of Anaesthetists states that opioids, including codeine, rarely result in addiction when taken by people in pain, but they can become less effective over time (opioid tolerance), dependency may develop, and withdrawal effects can occur when opiods are stopped or doses are decreased.[9]

Side effects of codeine and the similar drug dihydrocodeine are similar to those of other opioid drugs.

Commonly reported side effects in adults are:

Less common side effects include

Commonly reported side effects in children are:

  • breathing difficulties are more common in children and may be fatal
  • codeine has been increasingly restricted in under 18s due to safety risks

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  1. Peechakara, BV; Gupta, M (June 21, 2022). Codeine. Treasure Island (FL): StatPearls.
  2. Foley, M.; Harris, R.; Rich, E.; Rapca, A.; Bergin, M.; Norman, I.; Van Hout, M. C. (November 1, 2015). "The availability of over-the-counter codeine medicines across the European Union". Public Health. 129 (11): 1465–1470. doi:10.1016/j.puhe.2015.06.014. ISSN 0033-3506.
  3. "Co-codaprin: painkiller containing aspirin and codeine". NHS. August 29, 2018. Retrieved January 10, 2023.
  4. 4.0 4.1 4.2 West Hertfordshire Hospitals NHS Trust. "A Guide to Strong Opioids" (PDF). Retrieved January 10, 2023.
  5. Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Gerken, A; Jo, D; Lewis, DP; Light, AR; Light, KC; Marshall-Gradisnik, S; McLaren-Howard, J; Mena, I; Miwa, K; Murovska, M; Stevens, SR (2012), Myalgic encephalomyelitis: Adult & Paediatric: International Consensus Primer for Medical Practitioners (PDF), ISBN 978-0-9739335-3-6
  6. Carruthers, Bruce M.; Jain, Anil Kumar; De Meirleir, Kenny L.; Peterson, Daniel L.; Klimas, Nancy G.; Lerner, A. Martin; Bested, Alison C.; Flor-Henry, Pierre; Joshi, Pradip; Powles, A C Peter; Sherkey, Jeffrey A.; van de Sande, Marjorie I. (2003), "Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Clinical Working Case Definition, Diagnostic and Treatment Protocols" (PDF), Journal of Chronic Fatigue Syndrome, 11 (2): 7–115, doi:10.1300/J092v11n01_02
  7. "Understanding the Opioid Overdose Epidemic | Opioids". CDC. October 7, 2022. Retrieved January 10, 2023.
  8. 8.0 8.1 Center for Drug Evaluation and Research (December 28, 2018). "Codeine Information". FDA.
  9. "Taking Opioids for Pain | Information for Patients". The Royal College of Anaesthetists. 2016. Retrieved October 3, 2018.
  10. "Codeine". DrugBank. Retrieved January 10, 2023.