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Codeine CODEINE
Generic Name: codeine (KOE deen)
Paracetamol plus codeine is an effective analgesic combination, Codeine Paracetamol (narcotic) analgesics act on the central nervous system to relieve pain.

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What is the most important information I should know about codeine?
• 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 very uncomfortable. Your doctor may want to gradually reduce your dose.
• Codeine will cause drowsiness and fatigue. Avoid alcohol, sleeping pills, antihistamines, sedatives, and tranquilizers except under the supervision of your doctor. These may also make you drowsy.
• Codeine will also cause constipation. Drink plenty of water (six to eight full glasses a day) to lessen this side effect. Increasing the amount of fiber in your diet can also help to alleviate constipation.
• Never take more codeine than is prescribed for you. If your pain is not being adequately treated, talk to your doctor.

What is codeine?
• Codeine is in a class of drugs called narcotic analgesics. It relieves pain.
• Codeine is used to treat moderate-to-severe pain. Codeine is also a cough suppressant and an antidiarrheal medication.
• Codeine may also be used for purposes other than those listed in this medication guide.

Who should not take codeine?
• Codeine is habit forming and should only be used under close supervision if you have an alcohol or drug addiction.
• Before taking this medication, tell your doctor if you have
· kidney disease;
· liver disease;
· asthma;
· urinary retention;
· an enlarged prostate;
· hypothyroidism;
· seizures or epilepsy;
· gallbladder disease;
· a head injury; or
· Addison's disease.
• You may not be able to take codeine, or you may require a lower dose or special monitoring during treatment if you have any of the conditions listed above.
• 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.
• 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.
• 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.

How should I take codeine?
• 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.
• Store codeine at room temperature away from moisture and heat.

What happens if I miss a 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.

What happens if I overdose?
• Seek emergency medical attention.
• Symptoms of a codeine overdose include slow breathing, seizures, dizziness, weakness, loss of consciousness, coma, confusion, tiredness, cold and clammy skin, and small pupils.

What should I avoid while taking codeine?
• Avoid alcohol while taking codeine. Alcohol will greatly increase the drowsiness and dizziness caused by codeine and could be dangerous.
• Also avoid sleeping pills, tranquilizers, sedatives, and antihistamines except under the supervision of your doctor. These medications also may cause dangerous sedation.
• Use caution when driving, operating machinery, or performing other hazardous activities. Codeine may cause drowsiness. If you experience drowsiness, avoid these activities.

What are the possible side effects of codeine?
• If you experience any of the following serious side effects, stop taking codeine and seek emergency medical attention:
· an allergic reaction (difficulty breathing; closing of your throat; swelling of your lips, tongue, or face; or hives);
· slow, weak breathing;
· seizures;
· cold, clammy skin;
· severe weakness or dizziness; or
· unconsciousness.
• Other, less serious side effects may be more likely to occur. Continue to take codeine and talk to your doctor if you experience
· constipation;
· dry mouth, nausea, vomiting, or decreased appetite;
· dizziness, tiredness, or lightheadedness;
· muscle twitches;
· sweating;
· itching;
· decreased urination; or
· 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.

What other drugs will affect codeine?
• 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:
· antihistamines such as brompheniramine (Dimetane, Bromfed, others), diphenhydramine (Benadryl, Nytol, Compoz, others), chlorpheniramine (Chlor-Trimeton, Teldrin, others), and others;
· tricyclic antidepressants, such as amitriptyline (Elavil) and doxepin (Sinequan), and serotonin reuptake inhibitors such as fluoxetine (Prozac), sertraline (Zoloft), and paroxetine (Paxil);
· other commonly used antidepressants, including amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), imipramine (Tofranil), nortriptyline (Pamelor), and protriptyline (Vivactil);
· anticholinergics such as belladonna (Donnatal), clidinium (Quarzan), dicyclomine (Bentyl, Antispas), hyoscyamine (Levsin, Anaspaz), ipratropium (Atrovent), propantheline (Pro-Banthine), and scopolamine (Transderm-Scop);
· phenothiazines such as chlorpromazine (Thorazine), fluphenazine (Prolixin), thioridazine (Mellaril), and prochlorperazine (Compazine); and
· 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.

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