Codeine is an opioid analgesic and central antitussive agent primarily used to relieve moderate to severe pain and to treat dry coughs without phlegm. It acts on specific receptors in the nervous system to inhibit pain signal transmission and suppress the cough reflex.
This medication has addictive potential and associated risks, and must be used under a physician’s prescription. Although its analgesic effect is less potent than morphine, it is often used for short-term pain management or cough suppression due to its milder side effects. Strict adherence to medical instructions is essential, and self-adjustment of dosage should be avoided.
Brand names include Codralin, Empirin with Codeine, among others, but different countries or regions may have different commercial names. The generic name is "Codeine phosphate," usually available in tablet, liquid, or combination formulations.
In combination preparations, codeine is often combined with acetaminophen or ibuprofen to enhance analgesic effects. Patients should carefully read the medication packaging to confirm whether it contains codeine.
Codeine belongs to the opioid class (opioid alkaloids) and is classified as a central antitussive and a weak opioid analgesic. Its mechanism of action is similar to morphine but approximately one-twelfth as potent.
Within drug classification systems, it is also a controlled substance, subject to regulations such as the Narcotics Hazard Prevention Act. Due to its addiction potential and risk of misuse, Taiwan classifies it as a Schedule IV controlled drug.
Pregnancy safety category is C; use after the second trimester may increase the risk of neonatal respiratory depression. Use during breastfeeding may cause drowsiness or respiratory difficulties in the infant, requiring evaluation of risks and benefits by a healthcare provider.
If a dose is missed and the next dose is more than 4 hours away, the missed dose should be taken immediately. If the next dose is due within 2 hours, skip the missed dose and take the next dose as scheduled; do not double the dose to make up for the missed one.
If a missed dose leads to worsening symptoms (such as increased pain or uncontrollable cough), contact a healthcare provider immediately and do not increase the dose on your own. Setting medication reminders is recommended to prevent missed doses.
Can I take other pain medications simultaneously with codeine?
Avoid combining with other pain relievers containing codeine or opioids to reduce the risk of serious side effects such as respiratory depression. If non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are also needed, dose adjustments should be made under medical supervision, and close monitoring for gastrointestinal discomfort and interactions is advised.
What are the potential consequences of suddenly stopping long-term use of codeine?
Abrupt discontinuation after long-term use may cause withdrawal symptoms such as anxiety, muscle spasms, tearing, and rhinorrhea. It is recommended to gradually reduce the dose under medical guidance to avoid withdrawal. Severe discomfort should prompt immediate medical evaluation.
Can codeine affect driving or operating machinery?
Yes. The medication may cause dizziness, impaired concentration, or drowsiness, which can affect reaction times. Driving or operating hazardous machinery should be avoided during treatment, especially within 48 hours of initial use or after dose adjustments.
What precautions should be taken for patients with liver or kidney impairment?
Patients with liver or kidney dysfunction metabolize and eliminate the drug more slowly, increasing the risk of accumulation and toxicity. Physicians will adjust dosages based on liver and kidney function tests and may increase blood concentration monitoring. Regular follow-up is recommended.
Are there any common supplements that interact with codeine?
Consuming grapefruit juice may prolong the drug’s effect and increase the risk of respiratory depression; supplements like melatonin or vitamin K may also affect metabolism. Before using any over-the-counter medications or health supplements, inform your healthcare provider to avoid drug interactions.
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