Codeine
Codeine is an opioid medication used primarily as a cough suppressant and for the relief of mild to moderate pain. It works by binding to mu-opioid receptors in the brain, though its effects are weaker than morphine due to its conversion to morphine in the body. This medication is typically prescribed when non-opioid treatments have proven insufficient.
Codeine is an opioid analgesic and cough suppressant that provides relief by converting to morphine and binding to opioid receptors.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- R05DA04
- RxNorm
- 2670
- Generic
- Codeine
- Class
- atc-r05
- Brands
- Lortuss EX, M-End Max D, Ascomp, Zodryl DEC, Zodryl DAC, Zodryl AC, Ninjacof XG, Tuzistra, Tuxarin, Brontex, Fioricet with Codeine, Tylenol with Codeine, M-Clear WC, Maxiphen CDX, Ambifed-G CD
- Availability
- rx
- Lactation
- unknown
- Routes
- oral
- Forms
- tablet, suspension, solution, capsule
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 15-60mg every 4-6 hours as needed
- Maximum
- consult physician
- Frequency
- every 4-6 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 0.5-1mg/kg every 4-6 hours as needed
- Maximum
- consult physician
- Frequency
- every 4-6 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 15-30mg every 4-6 hours as needed
- Maximum
- consult physician
- Frequency
- every 4-6 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
10 groupspregnancy
first trimesteravoid if possible
avoid use during pregnancy unless benefits outweigh risks; use lowest effective dose for shortest duration
regular prenatal monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteravoid
avoid use near delivery; risk of neonatal opioid withdrawal syndrome (NOWS)
fetal monitoring and assessment for withdrawal symptoms in newborn
Use of this medication in this population requires careful consideration of risks and benefits.
lactation
breastfeedingavoid or discontinue breastfeeding
codeine is contraindicated in breastfeeding mothers who are ultra-rapid metabolizers; monitor infant for excessive drowsiness
monitor infant for sedation, breathing difficulties, and feeding problems
Use with caution and monitor for adverse effects.
geriatric
elderlyreduce initial dose by 25-50%
start with lowest effective dose; increased sensitivity to CNS effects; monitor for falls and constipation
regular assessment of pain control, sedation levels, and respiratory status
Use with caution and monitor for adverse effects.
pediatric_age
children under 12do not use
codeine is contraindicated in children under 12 years; contraindicated for tonsillectomy/adenoidectomy pain
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
pediatric_age
adolescents 12 18use with extreme caution, avoid if possible
use only for pain in children 12-18 after tonsillectomy/adenoidectomy is contraindicated; assess for ultra-rapid metabolism
close monitoring for respiratory depression and sedation
Use with caution and monitor for adverse effects.
renal_impairment
mildno adjustment needed for mild impairment
use with caution; monitor for prolonged effects
monitor renal function and drug response
Use with caution and monitor for adverse effects.
renal_impairment
severereduce dose by 50% and extend dosing interval
use reduced dose; avoid in severe renal impairment if possible
frequent monitoring of renal function and for signs of toxicity
Use with caution and monitor for adverse effects.
hepatic_impairment
mild to moderatereduce initial dose by 50%
use with caution; impaired metabolism of codeine to morphine
monitor for analgesic efficacy and respiratory depression
Use with caution and monitor for adverse effects.
hepatic_impairment
severeavoid
avoid use in severe hepatic impairment
not applicable
Use of this medication in this population requires careful consideration of risks and benefits.
Statistics and clinical data
Drug class
Codeine belongs to the opioid analgesic class of medications
Common uses
Primary therapeutic applications for codeine-containing products
Controlled substance status
Regulatory classification due to opioid properties
Commonly prescribed since
Historical prescribing information for codeine products
Codeine is used to treat cough associated with respiratory conditions and to relieve mild to moderate pain, often when other pain relievers have been ineffective. It may be prescribed for conditions such as cough from colds or flu, dental pain, and other acute pain scenarios.
Codeine is a relatively weak opioid agonist that selectively binds to mu-opioid receptors. Its analgesic effects are primarily due to its conversion to morphine by liver enzymes (CYP2D6). This conversion process varies among individuals, affecting the medication's efficacy and potential side effects.
Codeine carries risks of dependence, addiction, and respiratory depression, particularly in certain populations. It is contraindicated in children under 12 and in pregnant women near delivery. Due to variable metabolism, some individuals may experience enhanced effects or toxicity. Patients should be monitored for breathing difficulties and avoid alcohol while taking this medication.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed July 26, 2026. · Read our editorial policy