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Codeine

Authoring team

Codeine is an alkaloid obtained from opium or prepared from morphine by methylation.

It is used as a narcotic analgesic for mild to moderate pain, and as an antitussive. The phosphate and sulphate salts are soluble in water. It can be administered intravenously, intramuscularly or orally.

It is useful after head injury because it causes less respiratory depression than the other opiates.

This drug may cause constipation. It should not be used in those less than one year old.

Advice for healthcare professionals with respect to using codeine linctus (1):

  • codeine linctus is to be reclassified from a pharmacy-only medicine (P) to a prescription-only medicine (POM) owing to the risk of dependence, addiction, and overdose
  • codeine linctus is only authorised for the treatment of dry cough
  • codeine linctus is only considered to be effective in the treatment of chronic cough lasting over 8 weeks
  • advise patients that those with a long-term cough should see a healthcare professional, for review of symptoms and may require medical assessments to check for other conditions which may be the cause of the cough
  • we would encourage healthcare professionals to read the Summary of Product Characteristics for special warnings and contraindications for the use of codeine linctus, especially in patients with a history of substance abuse
  • record prescription details in the patient’s summary care record (or equivalent) and encourage patients to read the Patient Information Leaflet that comes with their medicine
  • report suspected adverse drug reactions to codeine linctus to the Yellow Card scheme

Reference:

  1. Drug Safety Update volume 17, issue 7: February 2024: 1

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