1. About codeine
Codeine is a painkiller. It is used to deal with ache, for instance after an operation or an harm. It is also used for long-standing ache when on a regular basis painkillers, resembling paracetamol, ibuprofen and aspirin haven’t labored.
Codeine can be used to deal with diarrhoea. Codeine is obtainable on prescription. It comes as tablets, a liquid to swallow and as an injection. Codeine injections are often solely given in hospital.
You should buy lower-strength codeine from a pharmacy. It comes combined with paracetamol (co-codamol) or with aspirin (co-codaprin) or with ibuprofen (Nurofen Plus).
You can even purchase codeine from a pharmacy as a syrup (linctus) to deal with dry coughs.
2. Key info
- Codeine works by stopping ache indicators from travelling alongside the nerves to the mind.
- The most typical unwanted side effects of codeine are constipation, feeling sick (nausea) and feeling sleepy.
- It is doable to turn into hooked on codeine, however your physician will clarify methods to cut back the dangers of changing into addicted.
- If you want to take codeine for various weeks, your remedy plan might embrace particulars of how and when to cease taking this medication.
- It might be finest to not drink alcohol whereas taking codeine as you are extra more likely to get unwanted side effects like feeling sleepy.
- Don’t give codeine to youngsters below 12 years outdated. Solely give codeine to youngsters aged 12 to 18 years if on a regular basis painkillers like paracetamol and ibuprofen have not labored.
3. Who can and might’t take codeine
Codeine will be taken by adults and youngsters aged 12 years and older. Solely give codeine to youngsters (aged 12 to 18 years) if on a regular basis painkillers resembling paracetamol and ibuprofen have not labored.
Codeine just isn’t appropriate for some folks. Inform your physician earlier than beginning the medication in case you have:
- had an allergic response to codeine or another medicines prior to now
- a lung drawback
- a head harm
- adrenal gland issues
- an sickness which causes seizures
- an dependancy to alcohol
- an underactive thyroid gland
- kidney or liver issues
- an enlarged prostate
- low blood stress
- myasthenia gravis (a uncommon sickness that causes muscle weak point)
- signs of ulcerative colitis (a bowel situation)
Don’t give codeine to youngsters who’re below 18 years outdated and have had their tonsils or adenoids eliminated due to a sleep drawback referred to as obstructive sleep apnoea.
Codeine just isn’t usually advisable in being pregnant. Inform your physician earlier than taking codeine in the event you’re attempting to get pregnant, are already pregnant or in case you are breastfeeding.
4. How and when to take it
Comply with your physician’s directions about methods to use this medication. That is significantly vital as a result of codeine will be addictive.
Take codeine with, or simply after, a meal or snack so it is much less more likely to make you are feeling sick.
You possibly can take codeine at any time of day however attempt to take it on the identical instances every single day and house your doses evenly.
Various kinds of codeine
Codeine comes as:
- tablets – these include 15mg, 30mg or 60mg of codeine
- a liquid that you just swallow – this comprises 25mg of codeine in a 5ml spoonful
- cough syrup – this comprises 15mg of codeine in a 5ml spoonful
- an injection (often given in hospital)
When you’re taking codeine as a liquid, it’s going to include a plastic spoon or syringe that can assist you measure the correct quantity. Ask your pharmacist for one if you do not have it. Don’t measure the liquid with a kitchen teaspoon as a result of it will not give the correct quantity.
The standard dose of codeine is 15mg to 60mg.
The standard dose for treating ache:
- adults often take one or two 30mg tablets each 4 hours, as much as a most of 8 tablets (240mg) in 24 hours
- youngsters (aged 12 to 17 years) often take one or two 30mg tablets (or one or two 5ml spoonfuls of liquid) each 6 hours
- aged folks or folks with kidney or liver issues often take a 15mg pill each 4 hours
The standard dose for treating diarrhoea:
- adults often take one or two 30mg tablets (or one or two 5ml spoonfuls of liquid)
- youngsters (aged 12 to 17 years) often take one or two 30mg tablets (or one or two 5ml spoonfuls of liquid)
- aged folks or folks with kidney or liver issues often take a 15mg pill
- You possibly can take this dose 3 or 4 instances a day.
The standard dose for treating a cough:
- adults and youngsters often take one or two 5ml spoonfuls of cough syrup 3 or 4 instances a day.
Necessary: Overdose warning
- It is vital to not take greater than your prescribed dose.
Don’t take greater than 4 doses of codeine in 24 hours in the event you’re:
- a baby (aged 12 to 17 years)
- taking a 60mg dose
Will my dose go up or down?
- When you get unwanted side effects your dose might go down.
- In case your signs do not go away, your dose may go up or chances are you’ll be prescribed a distinct medication.
- Speak to your physician in case your ache or diarrhoea is not relieved by the dose of codeine prescribed for you, or if unwanted side effects hassle you or do not go away.
How lengthy will I take it for?
You may solely must take codeine for a couple of days. Generally, chances are you’ll must take codeine for longer. However often a distinct medication might be prescribed for long run ache or diarrhoea, particularly in case you have unwanted side effects like constipation.
What if I overlook to take it?
- When you overlook to take a dose, examine the data on the affected person data leaflet contained in the packaging or ask your pharmacist or physician for recommendation on what to do.
- By no means take 2 doses on the identical time to make up for a forgotten one.
- When you typically overlook doses, it could assist to set an alarm to remind you. You may additionally ask your pharmacist for recommendation on different methods to recollect your medication.
What’s going to occur if I cease taking it?
If you want to take codeine for a very long time your physique can turn into tolerant to it.
This is not often an issue however you could possibly get disagreeable withdrawal signs in the event you cease taking it abruptly.
If you wish to cease taking codeine, speak to your physician first. Your dose will be decreased steadily so you aren’t getting disagreeable withdrawal signs.
When you cease taking it abruptly it may trigger disagreeable withdrawal signs resembling:
- feeling agitated
- feeling anxious
In case you have been taking codeine for various weeks don’t cease taking it with out talking to your physician first.
What if I take an excessive amount of?
It is vital to not take greater than your prescribed dose, even in the event you suppose it is not sufficient to alleviate your ache. Communicate to your physician first, in the event you suppose you want a distinct dose. Taking an excessive amount of codeine will be harmful.
When you’ve taken an unintended overdose chances are you’ll really feel very sleepy, sick or dizzy. You might also discover it tough to breathe. In severe circumstances you may turn into unconscious and may have emergency remedy in hospital.
The quantity of codeine that may result in an overdose varies from individual to individual.
Pressing recommendation: Contact 111 for recommendation now if:
- you have taken greater than your advisable dose of codeine
- Go to 111.nhs.uk or name 111
- When you go to A&E, don’t drive your self – get another person to drive you or name for an ambulance.
- Take the codeine field or leaflet contained in the packet plus any remaining medication with you.
When you’ve been prescribed codeine, it is significantly vital that you just:
- retailer it correctly and safely at residence
- maintain it out of the sight and attain of kids
- by no means give your medication to anybody else
- Return any unused codeine to your pharmacist. They’ll eliminate it.
5. Taking codeine with different painkillers
It is secure to take codeine with paracetamol, ibuprofen or aspirin (aspirin is appropriate for most individuals aged 16 years and over).
Some painkillers that you may purchase with no prescription from pharmacies include codeine. They embrace co-codamol, ibuprofen and codeine ( resembling Nurofen Plus) and Solpadeine.
Don’t take painkillers that you just purchase with codeine in alongside prescribed codeine. You may be extra more likely to get unwanted side effects.
6. Unintended effects
Like all medicines, codeine could cause unwanted side effects in some folks – however many individuals don’t have any unwanted side effects or solely minor ones.
The upper the dose of codeine the extra probability that you’ll get unwanted side effects.
Frequent unwanted side effects
Frequent unwanted side effects occur in additional than 1 in 100 folks. Speak to your physician or pharmacist if the unwanted side effects hassle you or do not go away:
- feeling or being sick (nausea or vomiting)
- feeling sleepy
- confusion, feeling dizzy and vertigo (a sensation of spinning)
- dry mouth
Critical unwanted side effects
Critical unwanted side effects occur in lower than 1 in 100 folks. Name a health care provider right away in the event you:
- have respiratory issue or quick shallow respiratory
- have muscle stiffness
- get signs of low blood stress which embrace feeling dizzy and drained
- Name 999 or go to A&E right away in case you have a match or seizure.
Critical allergic response
In uncommon circumstances, it is doable to have a severe allergic response (anaphylaxis) to codeine.
Rapid motion required:
- you get a pores and skin rash which will embrace itchy, crimson, swollen, blistered or peeling pores and skin
- you are wheezing
- you get tightness within the chest or throat
- you’ve bother respiratory or speaking
- your mouth, face, lips, tongue or throat begin swelling
- You may be having a severe allergic response and may have quick remedy in hospital.
- These should not all of the unwanted side effects of codeine. For a full record see the leaflet inside your medication packet.
- You possibly can report any suspected aspect impact utilizing the Yellow Card security scheme.
- Go to Yellow Card for additional data.
7. How to deal with unwanted side effects
What to do about:
- constipation – attempt to get extra fibre into your food regimen resembling recent fruit and greens and cereals. Attempt to drink a number of glasses of water or different non-alcoholic liquid every day. When you can, it could additionally assist to do some mild train. It is secure to make use of a laxative in case your constipation would not go away. Normally, lactulose is finest however examine with a pharmacist or physician first.
- feeling or being sick (nausea or vomiting) – take codeine with or simply after a meal or snack to ease emotions of illness. When you’re being sick, strive small frequent sips of water. This aspect impact ought to usually put on off after a couple of days. Speak to your physician about taking an anti-sickness medication if it carries on for longer.
- feeling sleepy – this aspect impact ought to go away inside a couple of days as your physique will get used to codeine. Speak to your physician if it carries on for longer.
- confusion, feeling dizzy and vertigo – if codeine makes you are feeling dizzy whenever you arise, strive getting up very slowly or keep sitting down till you are feeling higher. When you start to really feel dizzy, lie down in order that you do not faint, then sit till you are feeling higher. This aspect impact ought to put on off inside a couple of days as your physique will get used to codeine. Speak to your physician if it carries on for longer.
- dry mouth – strive chewing sugar-free gum or sucking sugar-free sweets. Your physician can even prescribe a synthetic saliva substitute to maintain your mouth moist. This comes as a twig, gel or lozenge.
- complications – it is secure to take an on a regular basis painkiller resembling paracetamol or ibuprofen. Speak to your physician if the complications worsen or last more than every week.
8. Being pregnant and breastfeeding
Codeine is not advisable throughout being pregnant and whereas breastfeeding.
In early being pregnant, it has been linked to issues within the unborn child. When you take codeine on the finish of being pregnant there is a threat that your new child child might get withdrawal signs or be born hooked on codeine.
Nonetheless, it is vital to deal with ache in being pregnant. For some pregnant girls with extreme ache, codeine is perhaps the best choice. Your physician is one of the best particular person that can assist you determine what’s best for you and your child.
For extra details about how codeine can have an effect on you and your child throughout being pregnant, go to the Greatest Use of Medicines in Being pregnant (BUMPS) web site.
Codeine and breastfeeding
Codeine is not often advisable in the event you’re breastfeeding. Small quantities of codeine cross into breast milk and might trigger respiratory issues within the child. Communicate to your physician as they are able to suggest a distinct painkiller.
Non-urgent recommendation: Inform your physician in the event you’re:
- attempting to get pregnant
9. Cautions with different medicines
Some medicines and codeine intrude with one another and enhance the probabilities of you having unwanted side effects.
Inform your physician in the event you’re taking any medicines:
- that can assist you sleep
- for despair – some varieties cannot be taken with codeine
- for hypertension
- to assist cease you feeling or being sick
- to deal with signs of an allergy
- to cut back rigidity or anxiousness
- for psychological well being issues
Mixing codeine with natural treatments and dietary supplements
It is not doable to say that complementary medicines and natural treatments are secure to take with codeine. They are not examined in the identical means as pharmacy and prescription medicines. They’re usually not examined for the impact they’ve on different medicines.
Necessary: Medication security
Inform your physician or pharmacist in the event you’re taking another medicines, together with natural medicines, nutritional vitamins or dietary supplements.
10. Frequent questions
Diarrhoea and vomiting
10 methods to cut back ache
Codeine: discussion board
British Ache Society: folks dwelling with ache
Opioid medicines and the chance of dependancy: data for sufferers on GOV.UK
- How does codeine work?
Codeine is from a gaggle of medicines referred to as opiates, or narcotics. It really works within the central nervous system and the mind to dam ache indicators to the remainder of the physique. It additionally reduces the anxiousness and stress attributable to ache.
When codeine blocks the ache, there are different negative effects – for instance gradual or shallow respiratory. It additionally slows down digestion, which is why codeine could cause constipation.
- How lengthy will it take to work?
This will depend on the kind of codeine you’re taking. A codeine injection right into a vein offers the quickest ache aid. It really works virtually right away.
Codeine tablets, liquid and cough syrup all work in 30 to 60 minutes, however they put on off after a couple of hours.
- Can I turn into hooked on codeine?
Sure, codeine is addictive. For that reason, your dose might be reviewed to ensure you are solely taking the quantity you want to management your ache, or diarrhoea.
Your remedy plan might embrace particulars of how and when you’ll cease taking codeine. If you want to take it for a very long time your physique can turn into tolerant to it. Meaning you want larger doses to manage your ache over time.
Some folks can turn into extra delicate to ache (hyperalgesia). If this occurs, your physician will cut back your dose steadily to assist these signs. Communicate to your physician in case you are anxious about tolerance, hyperalgesia or changing into addicted.
- How will I do know if I am hooked on it?
When you’re hooked on codeine, chances are you’ll need to take it extra typically or really feel agitated in the event you delay taking a dose for any cause. And in the event you cease taking codeine abruptly chances are you’ll endure from withdrawal signs.
Speak to your physician in the event you’re anxious about dependancy.
- Can I drink alcohol with it?
Consuming alcohol whilst you’re on codeine might make you are feeling extra sleepy or enhance the chance of great unwanted side effects. It is best to cease ingesting alcohol through the first few days of remedy till you see how codeine impacts you.
When you really feel sleepy with codeine, cease ingesting alcohol whilst you’re taking it.
- Is there any meals or drink I must keep away from?
You possibly can eat and drink usually whereas taking codeine.
- Can youngsters take codeine?
Don’t give codeine to infants and youngsters below 12 years outdated. Youngsters aged 12 to 18 years can take codeine for ache or diarrhoea – however provided that different medicines have not labored. Use the bottom dose that works for not more than 3 days. In the event that they nonetheless have signs after 3 days see a health care provider.
Codeine should not be given to youngsters aged 12 to 18 years if they’ve respiratory issues or if they’ve had their tonsils or adenoids eliminated due to obstructive sleep apnoea.
- Will it have an effect on my fertility?
When you’re taking codeine for a short while and at regular doses, there isn’t any agency proof that it may cut back fertility.
Nonetheless in the event you’ve been taking it for a very long time and also you’re involved about your fertility, otherwise you’re attempting to get pregnant, communicate to a pharmacist or your physician.
- Are there different painkillers I can strive?
The kind of painkiller that is finest will depend on what kind of ache you’ve. If codeine would not eliminate your ache or turns into much less efficient, speak to your physician.
- Is codeine a managed medication?
Codeine is a managed medication. This implies there are additional guidelines on the way it’s prescribed and disbursed to ensure it is not given to the improper particular person or misused. Nonetheless, this does not have an effect on you as a affected person. The principles solely apply to the pharmacy that dispenses it.
- Will it make me so sleepy I am unable to operate?
If you first take codeine, you may most likely really feel sleepy for a couple of days. However the sleepiness will put on off as your physique will get used to the medication.
You may discover you are much less alert. On this case, you may select to have lower than excellent ache aid as a trade-off.
- Can I drive or journey a motorbike?
Don’t drive a automobile or journey a motorbike if codeine makes you sleepy through the daytime, offers you blurred imaginative and prescient or makes you are feeling dizzy, clumsy or unable to pay attention or make choices. This can be extra doubtless whenever you first begin taking codeine however may occur at any time – for instance when beginning one other medication.
It is an offence to drive a automobile in case your capability to drive safely is affected. It is your duty to determine if it is secure to drive. When you’re in any doubt, don’t drive.
Even when your capability to drive just isn’t affected, the police have the correct to request a saliva pattern to examine how a lot codeine is in your physique. GOV.UK has extra data on the regulation on medicine and driving.
Speak to your physician or pharmacist in the event you’re not sure whether or not it is secure so that you can drive whereas taking codeine.
- Will it have an effect on my contraception?
Codeine would not have an effect on any kind of contraception, together with the mixed capsule or emergency contraception However, in case you are taking codeine as a result of you’ve extreme diarrhoea for greater than 24 hours, your contraceptive capsules might not shield you from being pregnant. Look on the capsule packet to seek out out what to do.
- Will leisure medicine have an effect on it?
When you take leisure medicine, resembling hashish, cocaine and heroin whilst you’re taking codeine, you are extra more likely to get the intense unwanted side effects of codeine together with respiratory difficulties, coronary heart issues, seizures and even go right into a coma.
Some leisure medicine, resembling hashish, may also enhance codeine unwanted side effects resembling sleepiness and dizziness.
Taking heroin whilst you’re on prescribed codeine is very harmful. You are extra more likely to get all of the unwanted side effects of codeine, together with dependancy.
Inform your physician in the event you suppose chances are you’ll take leisure medicine whilst you’re on codeine.