Codeine

There's separate information about lower-strength codeine that comes mixed with paracetamol (co-codamol) or ibuprofen (Nurofen Plus).

What codeine is for

Codeine is a type of strong painkiller called an opioid. It's used to treat pain, for example after an operation or an injury.

It's often used when other painkillers, such as paracetamol and ibuprofen, have not worked

Codeine can also be used to treat a dry or painful cough or diarrhoea.

How to take codeine

Codeine usually comes as tablets, or a liquid you swallow (oral solution).

How much you need to take and for how long depends on why you're taking it.

Always check the packet or leaflet that comes with your medicine. Ask a pharmacist or doctor for advice if you're not sure how to take it or have any problems taking it.

When taking codeine:

• swallow tablets whole with half a glass of water
• take it with or without food
• use the syringe or cup that comes with liquid codeine to help you measure out the right dose

If you miss a dose of codeine

If you forget to take a dose of codeine, take it as soon as you remember, unless it's nearly time for your next dose.

If it's nearly time for your next dose, skip the dose you missed and take your next dose at the usual time.

Do not take 2 doses to make up for a missed dose.

If you take too much codeine

Taking an extra dose of codeine can be dangerous.

Call NHS 111 if:

If you're told to go to A&E, do not drive. Ask someone to drive you or call 999 and ask for an ambulance.

Bring the codeine packet or leaflet inside it, any remaining medicine, and any other medicines you take.

How to stop taking codeine

If you need to take codeine for a long time, your body can become used to having it.

Do not stop taking it codeine suddenly because this can cause withdrawal symptoms such as feeling agitated or anxious.

Your doctor will gradually reduce your dose over several weeks or months. Always follow your doctor's advice.

It's possible to become addicted to codeine. Your doctor will make sure you're only taking the amount you need to control your pain.

Talk to your doctor if you're worried about addiction.

Side effects of codeine

Like all medicines, codeine can cause side effects, although not everyone gets them.

Common side effects

Common side effects of codeine include:

• constipation
• feeling sick (nausea) or being sick (vomiting)
• feeling sleepy or tired
• sweating

If you feel sleepy or tired after taking codeine, do not drive, ride a bike or use machinery until you no longer have these symptoms.

Speak to a pharmacist or doctor if:

Serious side effects

Codeine can sometimes cause serious side effects, although most of them are rare.

Possible serious side effects of codeine include:

• an allergic reaction (anaphylaxis) - causing symptoms such as a swollen throat or tongue, a raised, itchy rash and difficulty breathing
• slow, weak or shallow breathing
• an unusual heartbeat (palpitations)
• low blood pressure (hypotension) - causing symptoms such as confusion, blurred vision, feeling weak, lightheaded or dizzy

Call NHS 111 if:

More about side effects

These are not all the side effects of codeine.

For a full list, see the leaflet that came with your medicine or search for your medicine leaflet on the electronic medicines compendium website.

You can report any side effects you get on the Yellow Card website

Who can and cannot take codeine

Most adults and children aged 12 years and over can take codeine.

Codeine is not suitable for some people. For example, it may not be suitable if:

• you've had an allergic reaction to codeine or another opioid painkiller
• you have a liver or kidney condition
• you have lung problems, such as asthma
• you have ever had an addiction to alcohol, prescription medicines or recreational drugs
• you have an underactive thyroid (hypothyroidism) or problems with your adrenal glands (such as Addison's disease)
• you have an enlarged prostate
• you have low blood pressure (hypotension)
• you have a head injury
• you're under 19 years old and recovering from having your tonsils or adenoids removed because of obstructive sleep apnoea

Before taking codeine, tell your doctor if you have any medical conditions.

Breastfeeding and codeine

Tell your doctor if you're breastfeeding. Codeine is not usually used while breastfeeding because there's a risk it could cause side effects in your baby.

Pregnancy and codeine

Tell your doctor if you're trying for a baby, pregnant or you get pregnant while taking codeine.

Codeine is sometimes used during pregnancy if needed. Your doctor will talk to you about the risks and benefits of taking it while you're pregnant.

Find out more about taking codeine during pregnancy on the Bumps (Best Use of Medicines in Pregnancy) website

Taking codeine with other medicines, food and drink

There are some medicines, remedies and supplements that may not mix well with codeine.

These include:

• other opioid painkillers, such as co-codamol
• medicines for depression or another mental health condition
• some medicines to treat allergies (antihistamines)
• medicines to help stop you feeling or being sick
• other medicines to treat diarrhoea

Before taking codeine, tell your doctor if you're taking any other medicines, herbal remedies, vitamins or supplements.

Taking codeine together with recreational drugs, such as cannabis, cocaine, or heroin can increase the risk of serious side effects.

Food, drink and alcohol with codeine

You can eat and drink normally while taking codeine, but it's best not to drink alcohol because this can increase the risk of side effects.

Find out more about your medicine

To find out more about your medicine, you can:

• check the leaflet that comes with it
• search for your medicine leaflet on the electronic medicines compendium website
• speak to a pharmacist or doctor for advice

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