Brand
name: Codeine
((KOE-deen))
Codeine Sulfate acts as a narcotic analgesic.
Inactive Ingredients: Thetablets contain colloidal silicon dioxide,
microcrystalline cellulose, starch, sodium starch glycolate, and stearic
acid. Each tablet for oral administration contains: Codeine Sulfate
15,30, or 60 mg (WARNING: May be habit forming.) Chemically, Codeine
Sulfate is, Morphinan-6-ol ,7,8-didehydro-4,5-epoxy- 3-methoxy-17-methyl-(5a
,6a )-, sulfate (2:1) (salt), trihydrate.
Why is Celebrex prescribed?
Codeine is a narcotic medication used, often in combination with other
medications, to relieve mild to moderate pain. Codeine is habit forming
and should only be used under close supervision if you have an alcohol
or drug addiction.
Before Using Codeine
In deciding to use a medicine, the risks of taking the medicine must
be weighed against the good it will do. This is a decision you and
your doctor will make. The following should be considered:
Allergies : Tell your doctor if you
have ever had any unusual or allergic reaction to Codeine.
Pregnancy- Codeine may cause addiction and withdrawal symptoms as well as other
harmful effects in an unborn baby. Do not take codeine without first
talking to your doctor if you are pregnant.
Breast-feeding-
Codeine may also cause addiction and withdrawal symptoms in a nursing
baby. Do not take codeine without first talking to your doctor if
you are breast-feeding a baby.
Children and older adults-
If you are younger than 18 years of age or older than 60 years of age,
you may be more likely to experience side effects from codeine therapy.
Use extra caution.
Other medicines-
Always tell your doctor all medications you are taking, both prescription
and over-the-counter. Although certain medicines should not be used
together at all, in other cases different medicines may be used together
even if an interaction might occur. In these cases, your doctor may
want to change the dose, or other precautions may be necessary. It
is especially important that you observe the following and consult
your doctor:
* Avoid alcohol while taking codeine. Alcohol will greatly increase
the drowsiness and dizziness caused by codeine and could be dangerous.
* Do not take codeine if you have taken a monoamine oxidase inhibitor (MAOI)
such as isocarboxazid (Marplan), phenelzine (Nardil), or tranylcypromine (Parnate)
in the last 14 days. Dangerous side effects could result. * The most serious interactions affecting codeine are with those drugs that
also cause sedation. The following drugs may lead to dangerous sedation if
taken with codeine:
o antihistamines such as brompheniramine (Dimetane, Bromfed, others), diphenhydramine
(Benadryl, Nytol, Compoz, others), chlorpheniramine (Chlor-Trimeton, Teldrin,
others), and others
o tricyclic antidepressants, such as amitriptyline (Elavil) and doxepin (Sinequan),
and serotonin reuptake inhibitors such as fluoxetine (Prozac), sertraline (Zoloft),
and paroxetine (Paxil)
o other commonly used antidepressants, including amoxapine (Asendin), clomipramine
(Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline
(Pamelor), and protriptyline (Vivactil)
o anticholinergics such as belladonna (Donnatal), clidinium (Quarzan), dicyclomine
(Bentyl, Antispas), hyoscyamine (Levsin, Anaspaz), ipratropium (Atrovent),
propantheline (Pro-Banthine), and scopolamine (Transderm-Scop)
o phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin),
thioridazine (Mellaril), and prochlorperazine (Compazine)
o tranquilizers and sedatives such as phenobarbital (Solfoton, Luminal), amobarbital
(Amytal), secobarbital (Seconal), alprazolam (Xanax), diazepam (Valium), lorazepam
(Ativan), flurazepam (Prosom), and temazepam (Restoril).
* Do not take any of the drugs listed above without the approval of your doctor.
* Drugs other than those listed here may also interact with codeine. Talk to
your doctor and pharmacist before taking any prescription or over-the-counter
medicines. .
Other medical problems-
Codeine is habit forming and should only be used under close supervision
if you have an alcohol or drug addiction. Make sure you tell your
doctor if you have any other medical problems, especially:
* kidney disease * liver disease * asthma
* urinary retention
* an enlarged prostate
* hypothyroidism
* seizures or epilepsy
* a head injury
* Addison's disease
Proper use of this medicine
* Take codeine exactly as directed by your doctor. If you do not
understand these directions, ask your pharmacist, nurse, or doctor
to explain them to you.
* Never take more of this medication than is prescribed for you. Too much codeine
could be very harmful.
* Take each dose with a full glass of water.
* Take codeine with food or milk if it upsets your stomach.
* Do not stop taking codeine suddenly if you have been taking it continuously
for more than 5 to 7 days. Stopping suddenly could cause withdrawal symptoms
and make you feel uncomfortable. Your doctor may want to gradually reduce your
dose.
* Codeine will cause constipation. Increase the amount of fiber and water (six
to eight full glasses a day) in your diet to prevent constipation.
* Do not share this medication with anyone else.
* If taking codeine in liquid form, shake well before measuring a dose.
Missed dose
Take the missed dose as soon as you remember. Do not take a double
dose of this medication. Take your next dose 4 to 6 hours later.Serious
overdose with codeine is characterized by respiratory depression
(a decrease in respiratory rate and/or tidal volume, Cheyne-Stokes
respiration, cyanosis), extreme somnolence progressing to stupor
or coma, skeletal muscle flaccidity, cold and clammy skin, and sometimes
bradycardia and hypotension. In severe overdosage, apnea, circulatory
collapse, cardiac arrest and death may occur.
Treatment: Primary attention should be given to the re-establishment
of adequate respiratory exchange through provision of a patent airway
and the institution of assisted or controlled ventilation. The narcotic
antagonist naloxone is a specific antidote against respiratory depression
which may result from overdosage or unusual sensitivity to narcotics,
including codeine. Therefore, an appropriate dose of naloxone (usual
initial adult dose: 0.4 mg) should be administered, preferably by the
intravenous route and simultaneously with efforts at respiratory resuscitation.
Since the duration of action of codeine may exceed that of the antagonist,
the patient should be kept under continued surveillance and repeated
doses of the antagonist should be administered as needed to maintain
adequate respiration.An antagonist should not be administeredin the
absence of clinically significant respiratory or cardiovascular depression.Oxygen,
intravenous fluids, vasopressors and other supportive measures should
be employed as indicated.Gastric emptying may be useful in removing
unabsorbed drug.
Storage Codeine
* Keep this medication in the container it came in, tightly closed,
and out of reach of children.
* Store it at room temperature and away from excess heat and moisture (not
in the bathroom).
* Throw away any medication that is outdated or no longer needed.
* Talk to your pharmacist about the proper disposal of your medication.
Side Effects of Codeine without a prescription:
THE MAJOR HAZARDS OF CODEINE, AS OF OTHER NARCOTIC ANALGESICS,
ARE RESPIRATORY DEPRESSION AND, TO A LESSER DEGREE, CIRCULATORY DEPRESSION.
RESPIRATORY ARREST, SHOCK, AND CARDIAC ARREST HAVE OCCURRED.
The most frequently observed adverse reactions include lightheadedness,
dizziness, sedation, nausea, vomiting, and sweating. These effects
seem to be more prominent in ambulatory patients and in those who are
not suffering severe pain. In such individuals, lower doses are advisable.
Some adverse reactions may be alleviated in the ambulatory patient
if he lies down.
Other adverse reactions include the following:
Central Nervous System — Euphoria, dysphoria, weakness, headache,
insomnia, agitation, disorientation, and visual disturbances.Gastrointestinal — Dr.
mouth, anorexia, constipation, and biliary tract spasm.Cardiovascular — Flushing
of the face, bradycardia, palpitation, faintness, and syncope.Genitourinary— Urinary
retention or hesitancy, anti- diuretic effect, and reduced libido and/or
potency.Allergic— Pruritus,
urticaria, other skin rashes, edema, and, rarely, hemorrhagic urticaria.* If you experience any of the following serious side effects, stop
taking codeine and seek emergency medical attention:
o an allergic reaction (difficulty breathing; closing of your throat; swelling
of your lips, tongue, or face; or hives)
o slow, weak breathing
o seizures o cold, clammy skin
o severe weakness or dizziness
o unconsciousness
* Other, less serious side effects may be more likely to occur. Continue to
take codeine and talk to your doctor if you experience
o constipation o dry mouth, nausea, vomiting, or decreased appetite
o dizziness, tiredness, or lightheadedness
o muscle twitches o sweating o itching
o decreased urination
o decreased sex drive
* Codeine is habit forming. Do not stop taking it suddenly.
* Side effects other than those listed here may also occur. Talk to your doctor
about any side effect that seems unusual or that is especially bothersome.
PRECAUTIONS Codeine
Head Injury and Increased Intracranial Pressure :The respiratory depressant
effects of narcotics and their capacity to elevate cerebrospinal fluid
pressure may be markedly exaggerated
in the presence of head injury, other intracranial lesions or a pre-
existing increase in intracranial pressure. Furthermore, narcotics
produce adverse reactions which may obscure the clinical course of
patients with head injuries.
Acute Abdominal Conditions :The administration of codeine or other
narcotics may obscure the diagnosis or clinical course in patients
with acute abdominal conditions.
Special Risk Patients :Codeine should be given with caution to certain
patients such as the elderly or debilitated, and those with severe
impairment of hepaticorrenalfunction,
hypothyroidism, Addison's disease, and prostatic hypertrophy or urethral
stricture.IMPORTANT NOTE: This is a summary and does not contain all
possible information about this product. For complete information about
this
product or your specific health needs, ask your health care professional.
Always seek the advice of your health care professional if you have
any questions about this product or your medical condition. This information
is not intended as individual medical advice and does not substitute
for the knowledge and judgment of your health care professional. This
information does not contain any assurances that this product is safe,
effective, or appropriate for you.
USES: Codeine is used to treat mild to moderate pain.
It acts on certain centers in the brain and spinal cord to give you
pain
relief.
Codeine is a narcotic pain reliever related to morphine.
OTHER USES: This section contains uses of this drug that are not listed
in the approved professional labeling for the drug but that may be
prescribed by your health care professional. Use this drug for a condition
that is listed in this section only if it has been so prescribed by
your health care professional.Codeine may also be used to control a
cough.HOW TO USE: Take this medication by mouth as directed by your
doctor. Pain medications work best when taken at the first signs of
pain. If
you wait until the pain has worsened, the medication may not work as
well. The dosage is based on your medical condition and response to
therapy. For children, the dosage is also based on weight.For the liquid
form, measure the medication with the provided dose-measuring spoon
or device to make sure you have the correct dose. Do not use
a household spoon. If you are extremely drowsy after using this medication,
consult your doctor or pharmacist promptly. Your dosage may need to
be lowered.If so directed by your doctor, you may also use long-acting
narcotic medications for ongoing pain. In that case, this medication
might be
used when needed for sudden attacks of "breakthrough" pain.
Also follow your doctor's or pharmacist's instructions for the safe
use of non-narcotic pain relievers (e.g., acetaminophen, ibuprofen).
Ask your doctor or pharmacist if you have any questions about your
treatment.This medication may cause dependence, especially if it is
used regularly for a long period of time or if it is used in high doses.
In such cases,
if you suddenly stop this drug, withdrawal reactions may occur. Such
reactions can include restlessness, runny nose, watering eyes, trouble
sleeping, severe abdominal/muscle pain, nausea, vomiting, rapid breathing,
and fast heartbeat. Report any such reactions to your doctor immediately.
When stopping long-term, regular treatment with this drug, gradually
reducing the dosage as directed will help prevent withdrawal reactions.
Consult your doctor or pharmacist for more details.
Though it is very unlikely to occur, Codeine witjout a prescription
can also be habit-forming and may result in abnormal
drug-seeking
behavior
(addiction).
Do not
increase your dose, take it more frequently, or use it for a longer
period of time than prescribed. Properly stop the medication when so
directed. This will lessen the chances of becoming addicted.
When used for a long time, Codeine may not work as
well and may require different dosing. Talk with your doctor if this
medication
stops working well.
Inform your doctor if your pain persists or worsens.
SIDE EFFECTS: Nausea commonly occurs with the use of codeine and usually
goes away after the first few doses. Consult your doctor or pharmacist
about ways to decrease nausea (e.g., antihistamines, taking with food,
lying down for 1-2 hours with as little head movement as possible).
Lightheadedness, dizziness, drowsiness, dry mouth, flushing, vomiting,
constipation, and sweating may also occur. If any of these effects
persist or worsen, notify your doctor or pharmacist promptly.
To prevent constipation, maintain a diet adequate in fiber, drink
plenty of water, and exercise. If you become constipated while using
this drug, consult your pharmacist for help in selecting a laxative
(e.g., stimulant-type with stool softener).
Remember that your doctor has prescribed this medication because he
or she has judged that the benefit to you is greater than the risk
of side effects. Many people using this medication do not have serious
side effects.
Tell your doctor immediately if any of these unlikely but serious
side effects occur: slow/shallow breathing, mental/mood changes (e.g.,
agitation, confusion, restlessness), fast/slow/irregular heartbeat,
fainting, vision changes.
Tell your doctor immediately if any of these rare but very serious
side effects occur: severe stomach/abdominal pain, change in the amount
of urine, seizures.
A very serious allergic reaction to this drug is unlikely, but seek
immediate medical attention if it occurs. Symptoms of a serious allergic
reaction may include: rash, itching, swelling, hives, severe dizziness,
trouble breathing.This is not a complete list of possible side effects.
If you notice other effects not listed above, contact your doctor or
pharmacist.Contact your doctor for medical advice about side effects.
The following numbers do not provide medical advice, but in the US
you may report
side effects to the Food and Drug Administration (FDA) at 1-800-FDA-1088.
In Canada, you may call Health Canada at 1-866-234-2345.
PRECAUTIONS: Before taking codeine, tell your doctor or pharmacist
if you are allergic to it; or to other narcotic pain medications (e.g.,
morphine, hydrocodone, oxycodone); or to sulfites (found in some brands);
or if you have any other allergies.This medication should not be used
if you have certain medical conditions. Before using this medicine,
consult your doctor or pharmacist if you
have: severe breathing problems (e.g., respiratory depression, carbon
dioxide retention), a certain bowel disease (paralytic ileus), severe
infectious diarrhea (e.g., pseudomembranous colitis), intoxication
with medications that can cause drowsiness or slow/shallow breathing
(e.g., alcohol or tranquilizers/sedatives).Before using this medication,
tell your doctor or pharmacist your medical history, especially of:
abdominal problems (e.g., gallbladder
disease, pancreatitis, ulcerative colitis), adrenal gland problems
(e.g., Addison's disease), brain disorders (e.g., seizures, head injury,
tumor, increased intracranial pressure), heart problems (e.g., irregular
heartbeat, low blood pressure), kidney disease, liver disease, lung
diseases (e.g., chronic obstructive pulmonary disease-COPD, hypoxia,
emphysema), personal or family history of regular drug/alcohol abuse,
mental/mood disorders (e.g., toxic psychosis), spinal problem (kyphoscoliosis),
underactive thyroid (hypothyroidism), difficulty urinating (e.g., enlarged
prostate, urethral stricture).
This drug may make you dizzy or drowsy. Use caution while engaging
in activities requiring alertness such as driving or using machinery.
Avoid alcoholic beverages because they may increase the risk of this
drug's side effects.Before having surgery, tell your doctor or dentist
that you are using this medication.
To minimize dizziness and lightheadedness, get up slowly when rising
from a seated or lying position.Caution is advised when using this
drug in the elderly because they may be more sensitive to its effects,
especially slow/shallow breathing,
drowsiness, and difficulty urinating.This medication should be used
only when clearly needed during pregnancy. It is not recommended for
use for long periods or in high doses near
the expected delivery date because of the potential for harm to your
unborn baby. Discuss the risks and benefits with your doctor. Infants
born to mothers who have been using this medication for a long time
may have withdrawal symptoms such as irritability, abnormal/persistent
crying, vomiting, or diarrhea. Tell your doctor immediately if you
notice any of these symptoms in your newborn.
This drug passes into breast milk. While there have been no reports
of harm to nursing infants, consult your doctor before breast-feeding.
DRUG INTERACTIONS: Your healthcare professionals (e.g., doctor or
pharmacist) may already be aware of any possible drug interactions
and may be monitoring you for it. Do not start, stop or change the
dosage of any medicine before checking with them first.
This drug should not be used with the following medications because
very serious interactions may occur: narcotic antagonists (e.g., naltrexone,
naloxone).
If you are currently using any of these medications listed above,
tell your doctor or pharmacist before starting codeine.
Before using this medication, tell your doctor or pharmacist of all
prescription and nonprescription/herbal products you may use, especially
of: anticholinergic drugs (e.g., scopolamine), other medications for
pain (e.g., narcotic agonists/antagonists such as butorphanol/nalbuphine),
quinidine, cimetidine.
Tell your doctor or pharmacist if you also take drugs that cause drowsiness
such as: certain antihistamines (e.g., diphenhydramine), anti-seizure
drugs (e.g., carbamazepine), medicine for sleep or anxiety (e.g., alprazolam,
diazepam, zolpidem), muscle relaxants, narcotic pain relievers (e.g.,
hydrocodone), psychiatric medicines (e.g., chlorpromazine, risperidone,
amitriptyline, trazodone).
Check the labels on all your medicines (e.g., cough-and-cold products)
because they may contain drowsiness-causing ingredients. Ask your pharmacist
about the safe use of those products.This medication may interfere
with certain laboratory tests (including amylase and lipase tests),
possibly causing false test results. Make
sure laboratory personnel and all your doctors know you use this drug.This
document does not contain all possible interactions. Therefore, before
using this product, tell your doctor or pharmacist of all the
products you use. Keep a list of all your medications with you, and
share the list with your doctor and pharmacist.
OVERDOSE: If overdose is suspected, contact your local poison control
center or emergency room immediately. US residents can call the US
national poison hotline at 1-800-222-1222. Canadian residents should
call their local poison control center directly. Symptoms of overdose
may include: slow breathing, slow heartbeat, cold/clammy skin, loss
of consciousness.
NOTES: Do not share Codeine Free Rx with others. It
is against the law.
