Contraindicated in:
Ultra-rapid CYP2D6 metabolizers of codeine
;Children <12 yr, children <18 yr following tonsillectomy and/or adenoidectomy, and children 12–18 yr who are postoperative; have obstructive sleep apnea, obesity, severe pulmonary disease, or neuromuscular disease; or are taking other medications that cause respiratory depression (↑ risk of respiratory depression and death).
Use Cautiously in:
Avoid chronic use; prolonged use of opioids during pregnancy can result in neonatal opioid withdrawal syndrome
;CV: hypotension, bradycardia
Derm: flushing, sweating
EENT: blurred vision, diplopia, miosis
GI: constipation, nausea, vomiting
Neuro: confusion, sedation, dysphoria, euphoria, floating feeling, hallucinations, headache, unusual dreams
Resp: RESPIRATORY DEPRESSION (INCLUDING CENTRAL SLEEP APNEA AND SLEEP-RELATED HYPOXEMIA)
Misc: allodynia, opioid-induced hyperalgesia,
physical dependence
,psychological dependence
, toleranceDrug-drug:
Use with benzodiazepines or other CNS depressants, including other opioids, nonbenzodiazepine sedative/hypnotics, anxiolytics, general anesthetics, muscle relaxants, antipsychotics, and alcohol, may cause profound sedation, respiratory depression, coma, and death; reserve concurrent use for when alternative treatment options are inadequate.
CYP3A4 inhibitors, including erythromycin, clarithromycin, ketoconazole, itraconazole, and protease inhibitors, may ↑ levels and risk of respiratory depression.
Drug-Natural Products:
Renal Impairment
Therapeutic Classification: allergy, cold and cough remedies, antitussives, opioid analgesics
Pharmacologic Classification: opioid agonists
Absorption: 50% absorbed from the GI tract.
Distribution: Widely distributed to tissues.
Half-Life: 2.5–4 hr.
Schedule II (C-II)
Schedule III (C-III)
Schedule IV (C-IV)
Schedule V (C-V)depends on content
Advise patient to notify health care provider if pregnancy is planned or suspected or if breastfeeding. Inform patient of potential for neonatal opioid withdrawal syndrome with prolonged use during pregnancy. Monitor neonate for signs and symptoms of withdrawal symptoms (irritability, hyperactivity and abnormal sleep pattern, high-pitched cry, tremor, vomiting, diarrhea, failure to gain weight); usually occur the first days after birth. Monitor infants exposed to codeine through breast milk for excess sedation and respiratory depression.
NDC Code
