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What is Codeine?
Codeine is one of the natural isomers of methylated morphine. This opiate is used as an analgesic, cough suppressant and diarrhea suppressant. It is second only to morphine in percentage in opium, and is still extracted from the plant in some areas, although it is also produced synthetically.
How does Codeine work?
Codeine is used to relieve moderate pain and to suppress non productive chronic coughing.
What does Codeine look like?
Codeine is available as a white scored tablet of 15 mg, with 15 imprinted on the scored side and the “54 613” imprinted on the other. It is also available in 30 mg strength in round white scored tablet with 30 imprinted on the scored side and “54 783” imprinted on the other. It is also available as a 60 mg round white tablet with a score and the imprint “60” on one side and “54 412” imprinted on the other. The 15 and 30 mg tablets are usually supplied in a 25 unit blister pack while the 60 mg tablets are usually supplied in bottles of 100 tablets.
Codeine dosing and administration
The effect of codeine varies widely with different patients and dosage should always be individually titrated. The usual starting dose for adults is between 15 and 60 mg every for hours as needed for pain. No more than 360 mg should be given in any 24 hours. Dosage should be adjusted according to the dose required for adequate pain relief and the degree to which the patient tolerates the drug. Tolerance to codeine develops relatively rapidly and the frequency of side effects increases with dose. Codeine is therefore unsuitable for long-term use. Codeine therapy should never be stopped abruptly, instead the dosage should be tapered over several weeks to avoid withdrawal symptoms. Such symptoms may include yawning, weeping, nose and sinus irritation, heavy sweating, hot and cold flashes, myalgia and mydriasis, irritability, anxiety, joint pain insomnia, nausea vomiting diarrhea, hypertension and tachycardia..
Common adverse effects from Codeine
The most common side effects of codeine include lethargy, lightheadedness, vertigo, sedation, shortness of breath, nausea, vomiting, sweating and constipation. The most serious reactions may include respiratory and circulatory depression, respiratory arrest, cardiac arrest, shock, coma and death. Other less frequent reactions include mood swings, abdominal pain, itching, hypotension, palpitations, syncope, anorexia, diarrhea, dry mouth, gastrointestinal discomfort, pancreatitis, anxiety, headache, insomnia, and visual disturbances.
Interactions with Codeine
Codeine may interact with other opiates, antihistamines, antipsychotics, anxiolytics and all central nervous system depressants including alcohol, other classes of analgesics, anticholinergics, tricyclic antidepressants, monoamine oxidase inhibitors and metabolic enzymes.
Codeine warnings and precautions
Codeine may cause false results in some blood analysis tests. Like all opiates it has a high potential for addiction and should be prescribed with caution, particularly for patients with a history of any kind of substance abuse. For the same reason it should not be used for long-term treatment or in very high doses. The risk of adverse side effects of codeine is sharply increased if it is taken in conjunction with alcohol or other opiates or narcotics.