Codeine

Prescription drugs pain killers

Last published: July 21, 2021

What is codeine?

Codeine is an opioid.

Opioids interact with opioid receptors in the brain and bring about a range of responses, from feelings of pain relief to relaxation, pleasure and contentment.

Codeine is used for relief from various conditions, including:

  • mild to moderate pain
  • severe pain (when combined with aspirin or paracetamol)
  • dry irritating cough
  • diarrhoea
  • cold and flu (when combined with antihistamines and decongestants). 1

Some people use non-prescribed codeine as a coping mechanism for chronic pain, mental health issues such as depression or anxiety, or to get high.3 In Australia codeine is the most commonly used opioid, and can no longer be purchased over the counter.2

Codeine is usually swallowed and comes in different forms, including:

  • tablets
  • capsules
  • suppositories
  • soluble powders and tablets
  • liquids.1

Other names

Codeine may also be known by a brand or trade name. Some common examples are:

Generic name Brand names
Aspirin and codeine Aspalgin®, Codral Cold & Flu Original®
Ibuprofen and codeine Nurofen Plus®
Paracetamol and codeine Panadeine Forte®, Panamax Co®
Paracetamol, codeine and doxylamine Mersyndol® and Mersyndol Forte®, Panalgesic®

Effects of codeine

There is no safe level of drug use. Use of any drug always carries some risk – even medications can produce unwanted side effects. It’s important to be careful when taking any type of drug.

Codeine affects everyone differently, based on:

  • the person’s size, weight and health
  • whether the person is used to taking it
  • whether other drugs are taken around the same time
  • the amount taken.

Side effects

The most common side effects of codeine are:

  • dizziness
  • tiredness
  • confusion, difficulty concentrating
  • euphoria
  • restlessness
  • blurred vision
  • dry mouth
  • limbs feeling heavy or muscles feeling stiff
  • sweating
  • mild allergic rash, itching and hives
  • low blood pressure
  • decreased heart rate, palpitations
  • stomach-ache, nausea, vomiting, constipation
  • difficulty urinating.4 5

These side effects may disappear with continued treatment. However, if they persist, speak to a medical practitioner.

Overdose

If the dose is too high, you might overdose. Call an ambulance straight away by dialling triple zero (000) if you or someone else has any of these symptoms (ambulance officers don’t need to involve the police):

  • inability to pass urine
  • severe constipation and obstructed bowel
  • agitation
  • cold clammy skin with a bluish tinge
  • mental numbness
  • very slow, shallow breathing
  • hallucinations and sometimes seizures
  • coma and death.1

Long-term effects of codeine

Regular use of codeine may eventually cause:

  • constipation
  • reduced sex drive
  • irregular periods
  • tension and muscle twitches
  • needing to use more to get the same effect
  • tolerance and dependence on codeine
  • financial, work and social problems.1, 5, 6

The effects of taking codeine with other drugs, including alcohol, prescription medications and other over-the-counter medicines, are often unpredictable.1

Codeine taken with alcohol can cause mental clouding, reduced coordination and slow breathing.1

More on polydrug use

'Polydrug use’ is a term for the use of more than one drug or type of drug at the same time or one after another. Polydrug use can involve both illicit drugs and legal substances, such as alcohol and medications.

Withdrawal

Giving up codeine after a long time is challenging because the body has to get used to functioning without it. Please seek advice from a health professional.

Withdrawal symptoms usually start within a few hours after the last dose and become strongest between 48 and 72 hours.7 Symptoms include:

  • cravings for codeine
  • seeking codeine containing medicines 
  • dilated pupils
  • abdominal cramps, diarrhoea, nausea, vomiting
  • lack of appetite
  • flu like symptoms such as runny nose, sneezing, sweating, chills and fever
  • yawning and difficulty sleeping
  • trembling, aching muscles and joints
  • goosebumps
  • restlessness, irritability, nervousness, depression.4, 6, 5

Getting help

If your use of Codeine is affecting your health, family, relationships, work, school, financial or other life situations, you can find help and support.

Call 1300 85 85 84 to speak to a real person and get answers to your questions as well as advice on practical ‘next steps’.

You can also search our list of Support Services for services in your local area:

  1. Upfal J. Australian drug guide: the plain language guide to drugs and medicines of all kinds. 8th ed. Carlton, Vic, Australia: Black Inc., an imprint of Schwartz Publishing Pty Ltd; 2016.
  2. Cairns R, Schaffer AL, Brown JA, Pearson SA, Buckley NA. Codeine use and harms in Australia: evaluating the effects of re‐scheduling. Addiction. 2019;115(3):451-9.
  3. Van Hout MC, Rich E, Dada S, Bergin M. Codeine Is My Helper: Misuse of and Dependence on Codeine-Containing Medicines in South Africa. Qual Health Res. 2017;27(3):341-50.
  4. Upfal J. The Australian drug guide : every person's guide to prescription and over-the-counter medicines, street drugs, vaccines, vitamins and minerals. 7th edition. ed. Melbourne, Vic.: Black Inc.; 2006.
  5. Kane BM, Triggle DJ. Codeine. Triggle DJ, editor. New York: Chelsea House; 2007.
  6. Marshman JA, Brands B, Sproule B, Jacobs MR. Drugs & drug abuse: a reference text. 3rd ed. Marshman JA, Brands B, Sproule B, Jacobs MR, Kevin O'B F, Addiction Research Foundation of Ontario, editors. Toronto: Addiction Research Foundation; 1998.
  7. Mental Health and Drug & Alcohol Office. NSW Drug and Alcohol Withdrawal Clinical Practice Guideline. NSW Department of Health; 2007, reviewed 2018.

Explore opioids on the Drug Wheel

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Effects

blurred vision, confusion, constipation, difficulty urinating, dizziness, dry mouth, euphoria, heart palpitations, hives, itching, nausea, sweating, tiredness, treat cold and flu, treat cough, treat diarrhoea, treat severe pain, treats mild pain, vomiting

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