DRUG sheets
CODEINE:
Mechanism of Action
Binds t? opiate receptors in the CNS, causing inhibition of ascending pain pathway s, altering the
perception of and response to pain; causes cough suppression by direct central action in the
medulla; produces generalized CNS depression
Indications: Codeine is used to relieve mild to moderate pain. rt is also used , usually in combination with
other medications, to reduce coughing.
Dosages:
Children: Oral, 1.M ., SubQ: 0.5-1 mg/kg/dose every 4-6 hours as needed ; maximum : 60 mg/dos e
Adults: Oral: 30 mg every 4-6 hours as needed; patients with prior opiate exposure may requir e
higher initial doses. Usual range: 15-120 mg every 4-6 hours as needed
Oral, controlled release formulation (Codeine Cantin®, not available in U.S.): 50-300 mg eve ry
12 hours . Note: A patient's codeine requirement should be established using prompt release
formulations; conversion to long acting products may be considered when chronic, continuou s
treatment is required. Higher dosages should be reserved for use only in opioid-tolerant patien ts.
l.M., SubQ: 30 mg every 4-6 hours as needed; patients with prior opiate exposure may requir e
higher initial doses. Usual range: 15-120 mg every 4-6 hours as needed; more frequent dosin g
may be needed
Antilussive: Oral (for nonproductive cough) :
Children: 1-1.5 mg/kg/day in divided doses every 4-6 hours as needed: Alternative dose
according to age:
2-6 years: 2.5-5 mg every 4-6 hours as needed ; maximum : 30 mg/day
6-12 years: 5-10 mg every 4-6 hours as needed; maximum: 60 mg/day
Adults: I 0-20 mg/dose every 4-6 hours as needed; maximum: 120 mg/day
Precautions:
Do not use codeine if you have ever had an allergic reaction to a narcotic medicine ( exam ples
include codeine, methadone, morphine, Oxycontin, Darvocet, Percocet, Vicodin, Lo1iab , and
many others). You should also not take codeine if you are having an asthma attack or if you have
a bowel obstruction called paralytic ileus. Codeine may be habit-forming and should be used only
by the person it was prescribed for. Codeine should never be given to another person, es pecially
someone who has a history of drug abuse or addiction. Keep lhe medication in a secure place .
where others cannot get to it.
Before using codeir~e, tell your doctor if you are allergic to any drugs, or if you have:
• asthma, COPD, sleep apnea, or other breathing disorders;
/ /
,;
I
• liver or kidney disease·
• underactive thyroid; '
• cur:vature of the spine;
• a l~1story of head injury or brain tum or·
• epilepsy or other seizure disorder· ,
• low blood pressure; '
• gallbladder disease· • Add' I • ' rson s disease or other adrenal gland dis
orders;
• enlarged prostate, urination problem s·
• mental illness· or '
' • a history of drug or alcohol addictio
n.
FDA ~regnancy category C. Codeine m ay be harmful to an unborn baby, and co
uld cat_ise
breath mg problems or addiction/withdr awal symptoms in a newborn. Tell your
doctor .'f you are
pregnant or plan to become pregnant du ring treatment. Codeine can pass into br
east milk an~ may
harm a nursing baby. The use of codein e by some nursing mothers may lead to
life-threaten mg
side effects in the baby. Do not use this medication without telling your doctor
if you are breaS t-
feeding a baby.
Older adults may be more sensitive to t he effects ofthis' medicine.
Recommended Dosages
Same as dosages.
Concentrations: PREPARATIONS: Tablets: 15mg, 30m
g, 60mg. Elixir: 12mg/5ml (teaspoon).
Adverse Reactions: Get emergency medical help if you have
any of these signs of an allergic reactio n: hives;
difficulty breathing; swelling of your fac e, lips, tongue, or throat. Call your doc
tor at once if you
have any of these serious side effects:
• shallow breathing, slow heartbeat;
• feeling light-headed, fainting;
• confusion, agitation, hallucinations, unusual thoughts or behavior;
• seizure (convulsions); or
• problems with urination.
Less serious side effects include:
• feeling dizzy or drowsy;
• nausea, vomiting, constipation;
• sweating; • headache;
• trouble sleeping (insomnia);
• loss of interest in sex·
• dry mouth; '
• blurred vision- or , • mild skin rash.