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Codeine – Mild Opioid Analgesic & Antitussive (Rx / Controlled in Many Regions)

Codeine is a mild opioid analgesic and antitussive (cough suppressant) used for the treatment of mild to moderate pain and dry cough when other non-opioid options are not sufficient.

After administration, codeine is partially converted in the liver into morphine (via CYP2D6 enzyme), which provides its pain-relieving effect. Because of this conversion, response to codeine can vary significantly between individuals.

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 Tärkeimmät tiedot

• Active Ingredient: Codeine phosphate (commonly)
• Drug Class: Weak opioid analgesic
• Käyttöaiheet:
  • Mild to moderate pain
  • Dry, non-productive cough
• Mechanism of Action: Prodrug → partial conversion to morphine → μ-opioid receptor activation
• Reseptistatus: Monissa maissa luvanvarainen reseptilääke

 Määrittelyt

• Dosage Forms: Tablets, capsules, oral syrup
• Common Strengths: 15 mg, 30 mg, 60 mg (varies by country/formulation)
• Onset of Action: ~30–60 minutes
• Duration of Action: ~4–6 hours
• Half-Life: ~3–4 hours
• Metabolism: Hepatic (CYP2D6 → morphine, CYP3A4 pathways)
• Poistuminen: Munuaisperäinen
• Varastointi: Huoneenlämpö

 Annostus ja antotapa

• Usually taken every 4–6 hours as needed
• Often combined with paracetamol (acetaminophen) for stronger analgesic effect
• Dose must be individualized by a healthcare provider
• Use is generally recommended for short-term treatment only

 Yhteensopivuus / Soveltuvuus

• Patients with mild to moderate pain not controlled by non-opioids
• Treatment of dry cough (in some formulations)
• Short-term pain management under medical supervision
• Not typically used for long-term chronic pain due to dependence risk

 Varoitukset ja varotoimet

• Risk of dependence, tolerance, and misuse
• Can cause respiratory depression at high doses or in sensitive individuals
• Effectiveness varies due to genetic differences in metabolism (CYP2D6 variability)
• Avoid alcohol and sedatives due to increased CNS depression
• Use caution in children, elderly, and respiratory disease

 Vasta-aiheet

• Vakava hengitysvajaus
• Acute asthma without monitoring
• Tunnettu yliherkkyys opioideille
• Children in certain age groups (restricted in many countries)
• Käytettäväksi MAO-estäjien kanssa (joissakin tapauksissa)

Why Codeine Is Used

Codeine is used as a step-up mild opioid option when standard pain relievers are insufficient, and also as a cough suppressant in selected cases. It is generally reserved for short-term use under medical supervision due to its opioid properties.