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Codeine is a weak narcotic pain-reliever and cough suppressant similar to morphine and hydrocodone. In fact, a small amount of codeine is converted to morphine in the body. The precise mechanism of action of codeine is not known; however, like morphine, codeine binds to receptors in the brain (opioid receptors) that are important for transmitting the sensation of pain throughout the body and brain. Codeine increases tolerance to pain, decreasing discomfort, but the pain still is apparent to the patient. In addition to reducing pain, codeine also causes sedation drowsiness, and depresses breathing. Codeine frequently is combined with acetaminophen (Tylenol) or aspirin for more effective pain relief. Buy Codeine Online.
Codeine is used to treat mild to moderate pain and to relieve cough. Codeine is also occasionally used to treat diarrhea, although loperamide (which is available OTC for milder diarrhea), diphenoxylate, paregoric, or even laudanum (also known as Tincture of Opium) are more frequently used to treat severe diarrhea.
Codeine is marketed as both a single–ingredient drug and in combination preparations with the analgesic acetaminophen (paracetamol), as co–codamol, paracord, panadeine, Paramol, or the Tylenol With Codeine series (e.g., Tylenol 3 and 4 tablets and elixir); with the analgesic acetylsalicylic acid (aspirin), as co–codaprin; or with the NSAID (non–steroidal anti-inflammatory drug) ibuprofen, as Nurofen Plus. These combinations provide greater pain relief than either agent alone (drug synergy). Codeine is also commonly marketed in products containing codeine with other pain killers or muscle relaxers, as well as codeine mixed with phenacetin (Emprazil With Codeine No. 1, 2, 3, and 4), naproxen, indomethacin, diclofenac, and others as well as more complex mixtures including such mixtures as aspirin + paracetamol + codeine ± caffeine ± antihistamines and other agents such as those mentioned above.
Codeine–only products can be obtained with a prescription as a time-release tablet (e.g., Codeine Contin 100 mg and Perduretas 50 mg). Codeine is also marketed in cough syrups with zero to a half–dozen other active ingredients, and a linctus (e.g., Paveral) for all of the uses for which codeine is indicated.
Injectable codeine is available for subcutaneous or intramuscular injection; intravenous injection can cause a serious reaction that can progress to anaphylaxis. Codeine suppositories are also marketed in some countries
Codeine should be stored between 15 to 30 C (59 to 86 F).
PRESCRIBED FOR: Codeine is used for the relief of mild to moderately severe pain and for suppressing cough.
DOSING: The usual adult dose of codeine is 15-60 mg every 4-6 hours.
DRUG INTERACTIONS: Codeine can impair the thinking and physical abilities required for driving or operating machinery. Alcohol and other sedatives such as alprazolam (Xanax) can produce further brain impairment and even confusion when combined with codeine. Therefore, alcohol and other sedatives should be limited when taking codeine.
PREGNANCY: Safety during pregnancy has not been established. Codeine is generally avoided in pregnancy because it may cause fetal physical dependence, withdrawal, and growth retardation.
The most frequent side effects of codeine include lightheadedness, dizziness, nausea, vomiting, shortness of breath, and sedation. Other side effects include allergic reactions, constipation, abdominal pain, rash, and itching. Codeine is habit-forming. Mental and physical dependence can occur but are unlikely when used for short-term pain relief. If codeine is suddenly withdrawn after prolonged use, symptoms of withdrawal may develop. The dose of codeine should be reduced gradually in order to avoid withdrawal symptoms.
Codeine can be used as a recreational drug.
In some countries, cough syrups and tablets containing codeine are available without a prescription; some potential recreational users are reported to buy codeine from multiple pharmacies so as not to arouse suspicion. A heroin addict may use codeine to ward off the effects of withdrawal.
Codeine is also available in conjunction with the anti–nausea medication promethazine in the form of syrup. Brand named as Phenergan with Codeine or in generic form as promethazine with codeine. Called ‘syrup‘, this medication is quickly becoming one of the most commonly misused codeine preparations.
Codeine is also demethylated by reaction with pyridine to illicitly synthesize morphine, which can then be acetylated to make heroin (diacetylmorphine). Pyridine is toxic and possibly carcinogenic, so morphine illicitly produced in this manner (and potentially contaminated with pyridine) may be particularly harmful. Codeine can also be turned into α–chlorocodide, which is used in the clandestine synthesis of desomorphine (Permonid)
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