What is Codeine? Uses, Side Effects & Drug Abuse Information

Promethazine Codeine Uses

Follow your doctor’s instructions when taking this medication orally. You can choose to take it with or without food, and if you experience nausea, consuming it with a meal may alleviate this symptom. To reduce nausea further, consult your doctor or pharmacist for alternative methods, such as lying down for 1 to 2 hours with minimal head movement.

If you are using the liquid form of this medication, ensure precise measurement using a specialized measuring device or spoon. Avoid using a regular household spoon, which may result in an incorrect dosage.

The prescribed dosage depends on your medical condition and how you respond to treatment. Do not increase your dose or use this medication more frequently or for a longer duration than advised by your healthcare provider, as doing so may elevate your risk of experiencing adverse effects. Make sure to discontinue the medication as directed.

For the most effective pain relief, it’s important to use pain medications at the first signs of discomfort. Waiting until the pain intensifies may reduce the medication’s effectiveness.

If you are dealing with persistent pain, such as that caused by cancer, your doctor may recommend long-acting opioid medications. In such cases, this medication may be reserved for sudden, breakthrough pain when necessary. Your healthcare provider may also prescribe other pain relievers like acetaminophen or ibuprofen. Consult your doctor or pharmacist to ensure the safe use of codeine in conjunction with other medications.

Abruptly discontinuing this medication can lead to withdrawal symptoms, mainly if you’ve been using it for an extended period or at high doses. To avoid withdrawal, your doctor may gradually reduce your amount. Notify your doctor or pharmacist promptly if you experience withdrawal symptoms such as restlessness, changes in mood (including anxiety, sleep disturbances, or suicidal thoughts), watery eyes, runny nose, nausea, diarrhea, sweating, muscle discomfort, or abrupt behavioral changes.

If you use this medication over an extended period, its effectiveness may diminish. In such cases, discussing the situation with your doctor is essential if the medication no longer provides adequate relief.

While this medication is beneficial for many individuals, there is a potential for it to lead to addiction. The risk of addiction may be higher if you have a history of substance use disorder involving the overuse or dependence on drugs or alcohol. To mitigate this risk, adhere strictly to your prescribed dosage. If you seek more information, consult your doctor or pharmacist.

Should your pain persist or worsen, it’s essential to inform your doctor.

If you are using codeine to manage a cough, notify your doctor if your cough persists beyond 5 days or if your condition deteriorates.

Codeine Detox

Codeine detox is the process of safely removing codeine and its byproducts from the body. It’s the initial step in overcoming codeine dependence and addiction. The primary goal of a codeine detox is to manage and alleviate withdrawal symptoms while ensuring the individual’s safety and comfort.

Here are some key points to consider about codeine detox:

1. Medical Supervision: It’s generally recommended to undergo codeine detox under medical supervision, especially if codeine use has been long-term, at high doses, or if there are underlying health issues. Medical professionals can monitor the individual’s condition and provide appropriate interventions if necessary.
2. Tapering vs. Cold Turkey: Detox can be achieved by either gradually reducing the codeine dose (tapering) or discontinuing its use abruptly (going “cold turkey”). Tapering is often preferred because it can lead to less severe withdrawal symptoms.
3. Medication-Assisted Detox: In some cases, healthcare providers may use medications to manage withdrawal symptoms. For example, buprenorphine or methadone may be used to help ease the transition off codeine.
4. Withdrawal Management: Codeine withdrawal symptoms can be challenging. They typically include physical symptoms like nausea, vomiting, diarrhea, and muscle aches, as well as psychological symptoms like anxiety and cravings. Healthcare providers can offer medications and therapeutic interventions to manage these symptoms.
5. Psychological Support: Psychological support is crucial during detox. It can help individuals address the emotional and psychological aspects of addiction. Therapy, counseling, and support groups can be beneficial.
6. Nutrition and Hydration: Staying well-nourished and hydrated is important during detox. Codeine withdrawal can cause nausea and vomiting, making it essential to consume adequate fluids and nutrients.
7. Rest: Proper rest and sleep are important to aid in recovery and provide the body with the energy it needs to heal.
8. Safety: Safety is paramount during codeine detox. Medical supervision is critical, as complications can arise, and individuals can be at risk for dehydration, electrolyte imbalances, and other health issues.

After completing detox, individuals are encouraged to continue their recovery journey through substance abuse treatment programs and ongoing support. Detox alone does not address the underlying causes of addiction, so comprehensive treatment is essential to achieve long-term recovery. This may include therapy, counseling, support groups, and lifestyle changes to maintain sobriety.

Codeine Side Effects

You may experience side effects like nausea, vomiting, constipation, lightheadedness, dizziness, drowsiness, or sweating. If these effects persist or worsen, promptly inform your doctor or pharmacist.

It’s advisable to maintain a fiber-rich diet, stay adequately hydrated, and engage in regular physical activity to prevent constipation. You may also require a laxative; consult your pharmacist to determine the most suitable option.

To minimize the risk of dizziness and lightheadedness, rise slowly when transitioning from a seated or lying position.

It’s essential to remember that your doctor prescribed this medication because they have assessed that the benefits outweigh the potential side effects. Many individuals who use this medication do not experience severe side effects.

Promptly notify your doctor if you experience any severe side effects, which may include:

1. Disrupted breathing during sleep is known as sleep apnea.
2. Mental or mood changes, such as agitation, depression, or hallucinations.
3. Abdominal or stomach pain.
4. Difficulty urinating.
5. Rapid or slow heartbeat.
6. Changes in vision.
7. Signs of your adrenal glands not functioning correctly, like loss of appetite, unusual fatigue, or weight loss.

Seek immediate medical assistance if you encounter any highly severe side effects, such as:

1. Fainting.
2. Seizures.

It’s worth noting that codeine is metabolized into a potent opioid drug, morphine, in your body. This conversion occurs more rapidly and comprehensively than usual in some individuals, heightening the risk of highly severe side effects. If you observe any of the following, seek immediate medical attention:

1. Slow or shallow breathing.
2. Extreme drowsiness or difficulty waking up.
3. Confusion.

While an extremely severe allergic reaction to this medication is uncommon, seek immediate medical assistance if you experience any signs of a severe allergic response. These signs may encompass:

1. Skin rash.
2. Itching or swelling, particularly of the face, tongue, or throat.
3. Profound dizziness.
4. Difficulty breathing.

Codeine Withdrawal Timeline

The timeline for codeine withdrawal can vary from person to person, depending on factors like the individual’s usage pattern, dosage, and overall health. Generally, codeine withdrawal follows a pattern, but the specific duration and severity of symptoms can differ.

Here’s a general timeline of codeine withdrawal:

1-2 Days: Within the first day or two after the last dose, individuals may experience early withdrawal symptoms, which can include:

• Anxiety
• Restlessness
• Insomnia
• Muscle aches and pains
• Runny nose
• Sweating

2-4 Days: As withdrawal progresses, symptoms may intensify and can include:

• Nausea and vomiting
• Diarrhea
• Abdominal cramps
• Dilated pupils
• Goosebumps (hence the term “cold turkey”)

5-7 Days: This is often considered the peak of withdrawal, with symptoms at their most intense during this period. These symptoms may include:

• Severe anxiety and depression
• Intense cravings
• Shakiness and tremors
• Rapid heart rate
• Elevated blood pressure
• Chills and fever-like symptoms

After 1-2 Weeks: The intensity of withdrawal symptoms gradually starts to subside. Physical symptoms may improve, but psychological symptoms like anxiety and cravings may persist. Sleep disturbances and fatigue may also continue.

Weeks to Months: Some individuals may experience post-acute withdrawal symptoms (PAWS), which can persist for weeks or even months. These symptoms can include mood swings, depression, anxiety, and ongoing drug cravings.

It’s important to note that withdrawal symptoms from Codeine can vary in severity, and not everyone will experience all of these symptoms. The timeline can also be influenced by factors such as the individual’s overall health, the duration and dosage of codeine use, and the presence of any co-occurring medical or mental health conditions.

Seeking professional medical guidance and support is highly recommended for individuals going through codeine withdrawal. Healthcare providers and addiction specialists can provide tailored treatment plans to manage symptoms and reduce the risk of relapse. The process can be challenging, but with appropriate care, recovery is possible.

Withdrawal Symptoms Of Codeine

Withdrawal symptoms of codeine can be uncomfortable and challenging, but they are typically a sign that the body is adjusting to the absence of the drug. The specific symptoms and their intensity can vary from person to person, depending on factors like the duration and dosage of codeine use, individual physiology, and whether codeine was misused or taken as prescribed. Common withdrawal symptoms of codeine can include:

1. Anxiety: Feelings of unease, nervousness, and restlessness.
2. Insomnia: Difficulty falling asleep or staying asleep.
3. Muscle Aches and Pains: General discomfort and body aches.
4. Runny Nose and Sneezing: Cold-like symptoms, including a runny nose and frequent sneezing.
5. Sweating: Excessive sweating, especially at night.
6. Yawning: Frequent and excessive yawning.
7. Dilated Pupils: Enlarged pupils, which can lead to sensitivity to light.
8. Goosebumps: “Gooseflesh” or goosebumps on the skin (hence the term “going cold turkey”).
9. Nausea: Feelings of queasiness and a strong urge to vomit.
10. Vomiting: Actual vomiting, which may occur in more severe cases.
11. Diarrhea: Frequent, loose bowel movements.
12. Abdominal Cramps: Pain and discomfort in the abdominal area.
13. Tremors: Shaking or tremors in the hands or other body parts.
14. Mood Changes: These can include irritability, depression, and anxiety.
15. Cravings: A strong desire or craving for the drug.

In severe cases of codeine withdrawal, individuals may experience more intense symptoms, including high blood pressure, rapid heart rate, and severe anxiety. In very severe cases, symptoms of Codeine withdrawal can be life-threatening, such as those associated with delirium tremens or seizures, although this is less common with codeine than with other opioids like heroin.

If you or someone you know is experiencing codeine withdrawal symptoms, it is advisable to seek professional help. Healthcare providers and addiction specialists can provide guidance, support, and treatment options to manage withdrawal symptoms and facilitate a safe recovery process. Additionally, they can assist in addressing the underlying causes of codeine dependence and addiction.

Codeine Warnings

Codeine risks abuse and addiction, potentially leading to overdose and fatal outcomes. Additionally, it may induce severe, and sometimes lethal, respiratory difficulties. To minimize these risks, your doctor should prescribe the lowest effective dose of codeine for the shortest duration possible.

Consult your doctor or pharmacist about the availability of naloxone for treating opioid overdose. Educate your family or household members about recognizing the signs of opioid overdose and how to respond.

The likelihood of severe breathing issues is more significant when initiating this medication, after a dosage increase, or if the wrong dose/strength is taken. Concurrent use of codeine with alcohol or other substances that induce drowsiness or breathing problems can result in serious side effects, including death. Moreover, various medications can affect the elimination of codeine from your system, potentially impacting its effectiveness. Seek immediate medical assistance if you experience these severe side effects: slow or shallow breathing, unusual lightheadedness, extreme drowsiness or dizziness, and difficulty waking up.

Safeguard this medicine securely to prevent theft, misuse, or abuse. If someone unintentionally ingests this medication, seek immediate medical assistance.

Before using this medication, women of childbearing age should discuss its risks and benefits with their doctor(s). Notify your doctor of your pregnancy or plans for pregnancy. This medication should only be used during pregnancy when necessary, as its use during the first two months may slightly increase the risk of birth defects.

Prolonged, high-dose usage near the expected delivery date can also pose risks to the unborn child. To mitigate these risks, take the smallest effective dose for the shortest duration possible. Infants born to mothers who have used this medication extensively may experience severe (possibly fatal) withdrawal symptoms. Notify your doctor immediately if you observe any symptoms in your newborn, such as constant crying, slow or shallow breathing, irritability, trembling, vomiting, diarrhea, poor feeding, or difficulty gaining weight.

Individuals under the age of 18 should refrain from using products containing codeine. Certain children, due to their heightened sensitivity, have experienced severe (and rarely fatal) respiratory issues, including slow or shallow breathing (refer to the Side Effects section for more details). This risk is amplified in children who are obese, those with preexisting breathing difficulties, or those who have undergone specific surgeries, such as tonsil or adenoid removal. It is essential to engage in discussion with your doctor or pharmacist to assess the potential advantages and disadvantages of using this medication.

Codeine Risks

Before taking codeine, you must inform your doctor or pharmacist about any allergies, whether they are related to codeine, other opioid pain medications (like morphine), or any other allergens. Some formulations of this product may include inactive components (such as sulfites present in certain brands) that can potentially trigger allergic reactions or other complications. Consult your pharmacist for further information.

Before using this medication, disclose your medical history to your doctor or pharmacist, particularly if you have an account of:

1. Brain disorders (e.g., head injury, tumors, seizures).
2. Respiratory issues (such as asthma, sleep apnea, chronic obstructive pulmonary disease).
3. Gallbladder disease.
4. Kidney disease.
5. Liver disease.
6. Mental or mood disorders (like confusion, depression, or thoughts of suicide).
7. Personal or family history of substance use disorder (involving excessive use or addiction to drugs or alcohol).
8. Obesity.
9. Gastrointestinal problems (including blockages, constipation, infection-induced diarrhea, paralytic ileus).
10. Pancreatic disease (pancreatitis).
11. Difficulty urinating (e.g., due to an enlarged prostate).

This medication can induce dizziness or drowsiness. The consumption of alcohol or marijuana (cannabis) can exacerbate these effects. Refrain from activities that demand alertness, such as driving or operating machinery, until you can do so safely. Avoid alcoholic beverages, and discuss marijuana (cannabis) use with your doctor.

Before surgery, ensure that both your doctor and dentist know all the products you are using, including prescription drugs, nonprescription drugs, and herbal supplements.

Older adults may exhibit increased sensitivity to the side effects of this medication, especially experiencing confusion, dizziness, drowsiness, and slow or shallow breathing.

While pregnant, this medication should be utilized exclusively when it is essential, as it may pose risks to an unborn baby. Engage in a conversation with your doctor to thoroughly evaluate the advantages and disadvantages of its use during pregnancy (also refer to the Warning section).

This medication can enter breast milk, potentially leading to adverse effects on a nursing infant, including unusual drowsiness, feeding difficulties, breathing problems, or unusual limpness. Therefore, it is advisable to consult with your doctor before breastfeeding.

The Dangers Of Cough Syrup With Codeine

Cough syrup containing codeine can be associated with several dangers, including:

1. Addiction and Dependence: Codeine is an opioid; like other opioids, it has a potential for addiction and dependence. People who misuse or abuse codeine-containing cough syrup can develop a tolerance, meaning they need higher doses to achieve the same effect and may become physically or psychologically dependent on it.
2. Respiratory Depression: Codeine can depress the respiratory system, leading to slow and shallow breathing. In high doses or when combined with other respiratory depressants like alcohol, this can be life-threatening.
3. Sedation: Codeine can cause drowsiness and impair cognitive and motor skills. Operating heavy machinery or driving while under the influence of codeine can be dangerous.
4. Constipation: Opioids, including codeine, can lead to severe constipation, which may require treatment with laxatives.
5. Nausea and Vomiting: Some individuals may experience nausea and vomiting as side effects of codeine.
6. Allergic Reactions: Allergic reactions to codeine can range from mild skin rashes to severe anaphylactic reactions.
7. Interaction with Other Medications: Codeine can interact with other medications, including those that affect the central nervous system, potentially leading to dangerous side effects or decreased effectiveness of either medication.
8. Overdose: Taking excessive amounts of codeine or combining it with other substances like alcohol or other opioids can lead to overdose, which can be fatal. Overdose symptoms may include slow or difficult breathing, extreme drowsiness, confusion, and even loss of consciousness.
9. Withdrawal Symptoms: When a person who has become dependent on codeine stops using it, they may experience withdrawal symptoms, including anxiety, restlessness, muscle aches, and more.
10. Misuse and Abuse: Codeine-containing cough syrup is often misused for recreational purposes. People may drink excessive amounts of the syrup, which can lead to dangerous health consequences.

It’s crucial to use cough syrup with codeine only as directed by a healthcare professional and to be aware of its potential risks. Suppose you have concerns about a cough or need medication for pain or cough relief. In that case, it’s advisable to consult with a healthcare provider who can recommend safer alternatives or monitor your usage to minimize potential risks.

Codeine Interactions

Interactions between drugs can alter how your medications function and potentially heighten the risk of severe side effects. This document does not encompass all conceivable drug interactions. Maintaining a record of all your products containing prescription and over-the-counter drugs and herbal supplements is essential, and sharing this list with your doctor and pharmacist. Do not initiate, discontinue, or modify any medication dosage without your doctor’s approval.

Certain products that may interact with this medication include pain medications, such as mixed opioid agonist-antagonists like butorphanol, nalbuphine, and pentazocine, as well as naltrexone and samidorphan.

The likelihood of severe side effects, such as slow or shallow breathing, profound drowsiness, or dizziness, may be amplified when this medication is taken with other products that can induce drowsiness or respiratory problems. Inform your doctor or pharmacist if you are using additional products like other opioid pain relievers or cough suppressants (such as morphine, hydrocodone), alcohol, marijuana (cannabis), sleep aids or anxiety medications (such as alprazolam, lorazepam, zolpidem), muscle relaxants (like carisoprodol and cyclobenzaprine), or antihistamines (such as cetirizine and diphenhydramine).

Examine the labels of all your medications, including allergy or cough-and-cold products, as they might encompass ingredients that induce drowsiness. Seek guidance from your pharmacist on how to safely use these products.

Various other medications have the potential to influence how your body metabolizes codeine, which, in turn, may impact its effectiveness. Examples include azole antifungals like ketoconazole, bupropion, fluoxetine, macrolide antibiotics such as erythromycin, paroxetine, quinidine, rifamycins like rifabutin and rifampin, ritonavir, and certain antiseizure medications like carbamazepine and phenytoin, among others.

Additionally, it’s essential to be aware that this medication might interfere with specific laboratory tests, like amylase and lipase levels, potentially resulting in inaccurate test outcomes. Therefore, ensure that both laboratory staff and all your healthcare providers are informed about your use of this drug.

Codeine Overdose

If an individual has overdosed and exhibits severe symptoms like losing consciousness or experiencing breathing difficulties, administer naloxone immediately if accessible, and then dial 911 for emergency assistance. If the person is awake and lacks symptoms, contact a poison control center directly.

Codeine Imprints

Below is a dosage chart providing information about Codeine dosage ranges, imprints, color, shape, and tablet versus capsule classification.