Codeine can cause breathing problems that are life-threatening, especially in the first 24 to72 hours of treatment or when your dose is increased. During your treatment, you will be closely monitored by your doctor. Tell your doctor about any asthma or breathing problems you may have had in the past. You will likely be told by your doctor not to take any codeine. Tell your doctor about any lung conditions, such as COPD (a group of diseases affecting the lungs and the airways), head injuries, brain tumours, or other conditions that increase the pressure on your brain. You are more likely to develop breathing issues if you’re an older adult, or if you’re weak or malnourished as a result of disease. Call your doctor or seek emergency medical attention if you notice any of these symptoms: slow breathing, long gaps between breaths or shortness.

Codeine use in children can cause serious breathing problems, including slow breathing or difficulty breathing. Deaths have also been reported. Codeine is not recommended for treating pain or coughs in children under 18 years old. Talk to your doctor about alternative treatments if your child has been prescribed codeine-containing cough and cold medicines.

Take certain medications while taking codeine to increase your risk of breathing problems. This includes breathing problems that are life-threatening, such as coma, sedation or breathing problems. Tell your doctor if any of these medications are being taken or will be taken: certain antibiotics like erythromycin, certain antifungal medicines such as ketoconazole, benzodiazepines, such as alprazolam and diazepam. You may be monitored by your doctor as he or she changes the dosage of your medication. You should call your doctor or go to an emergency room if you experience any of the symptoms listed below after taking codeine and any of these medicines: unusual dizziness or lightheadedness; extreme sleepiness; slowed breathing or difficulty breathing; or inability to respond. Make sure your family or caregiver knows which symptoms are serious, so that they can contact the doctor if necessary.

You are also more likely to experience serious and life-threatening effects if you drink alcohol or use street drugs while taking codeine. You should not consume alcohol or take non-prescription or prescription medications that contain alcohol or street drugs while you are receiving treatment.

Inform your doctor immediately if you plan to get pregnant. Your baby could experience life-threatening withdrawals symptoms if you regularly take codeine during pregnancy. If your baby exhibits any of these symptoms, you should immediately contact your doctor.

Don’t let anyone else take your medication. Codeine can cause harm or death to others who take your medication. This is especially true for children.

When you start treatment with codeine, your doctor or pharmacist will provide you with the patient information sheet from the manufacturer (Medication Guide). This information is also provided each time you renew your prescription. Ask your doctor or pharmacist any questions you may have. You can also visit the Food and Drug Administration (FDA) website (http://www.fda.gov/Drugs/DrugSafety/ucm085729.htm) or the manufacturer’s website to obtain the Medication Guide.

Before taking codeine,

• Tell your doctor if any of the conditions listed in the IMPORTANT WORTHY section are present, such as a narrowing or blockage of your stomach, intestines or paralytic ileus. You may be told by your doctor not to take any codeine.
• Tell your doctor if drinking alcohol or undergoing recent abdominal or urinary system surgery. Tell your doctor if any of the following conditions exist or you’ve ever experienced them: seizures, mental illness, prostatic hypertrophy, urinary problems, low blood pressure, Addison’s disease, thyroid, pancreatic or intestinal disease, liver or kidney disease, and Addison’s disease.
• You should be aware that codeine can decrease fertility both in men and women. Codeine can cause serious side effects. Discuss this with your doctor.
• Tell your doctor if breastfeeding is a possibility. Codeine should not be taken while breastfeeding. Codeine can cause confusion, sleepiness or more than usual, shallow breathing or difficulty breastfeeding.
• Tell your doctor or dentist if you’re having dental surgery that you take codeine.
• You should be aware that this medication can make you sleepy. You should not drive or operate any machinery until you have fully understood how the medication will affect you.
• You should be aware that codeine can cause dizziness and lightheadedness when you stand up quickly after lying down. It is more common to experience this when taking your first dose of codeine. Avoid this problem by getting out of bed slowly and resting your legs on the floor before standing.
• You should be aware that codeine can cause constipation. Consult your doctor to discuss changing your diet or using other medications to prevent or treat constipation.

What are the special dietary guidelines I should follow?

Continue your usual diet unless your doctor advises otherwise.

What should I do in the event that I forget to take a dose of medication?

Codeine is normally taken only when needed. If you have been told by your doctor to take codeine on a regular basis, you should take the missed dose immediately. If it’s almost time for your next dose, you can skip the missed dose. Don’t take two doses to make up for one missed.

What are the possible side effects of this drug?

Codeine may cause side effects. If any of these symptoms persist or are severe, tell your doctor.

•  
• stomach pain
• Urination problems

Some side effects are serious. You should stop taking codeine immediately if you experience any of these symptoms, or those listed under the WARNINGS section. Call your doctor or seek emergency medical care.

• Agitation, hallucinations, (seeing or hearing things that don’t exist), sweating, confusion and fast heartbeat. Shivering or severe muscle stiffness, twitching or jerking, loss of coordination or nausea.
• Dizziness, nausea, vomiting or weakness
• Inability to maintain or get an erection
• Menstruation irregular
• Sexual desire decreased
• Noisy or shallow breathing
• Having difficulty swallowing or breathing
• changes in heartbeat
• Rash
• Itching
• Hives
• Changes in Vision
• seizures

Codeine can cause side effects. If you experience any strange symptoms while taking this medication, call your doctor.

If you experience a serious side effect, you or your doctor may send a report to the Food and Drug Administration’s (FDA) MedWatch Adverse Event Reporting program online (http://www.fda.gov/Safety/MedWatch) or by phone (1-800-332-1088).

What do I need to know about the storage and disposal of my medication?

Store this medication at room temperature, away from excess heat and moisture (not in the bathroom), and tightly closed. Store the medication at room temperature, away from heat and moisture. (Not in the bathroom).

Many containers, such as those used for eye drops and creams, patches and inhalers, are not child resistant and can be opened by young children. Always lock safety caps, and place medication up and away from children’s sight and reach. http://www.upandaway.org

It is important to dispose of unwanted medications in a way that prevents pets, children and other people from consuming them. You should not flush the medication down your toilet. The best way to get rid of your medications is by using a medication take-back program. To find out about the take-back program in your area, talk to your pharmacist or your local recycling/garbage department. See the FDA’s Safe Disposal of Medicines website (http://goo.gl/c4Rm4p) for more information if you do not have access to a take-back program.

In the event of an emergency/overdose

Call the poison control helpline at 1-888-222-1222 in case of an overdose. Information is also available online at https://www.poisonhelp.org/help. Call 911 if the victim is unconscious, collapsed, has had a seizure or has difficulty breathing.

You should discuss with your doctor the possibility of having a naloxone rescue medication readily available at home or in the office (e.g.). Naloxone can reverse the potentially life-threatening effects caused by an overdose. It blocks the effects of opiates, relieving dangerous symptoms that are caused by high levels opiates in blood. You may be prescribed naloxone by your doctor if there are children in the household or if someone has used street drugs or prescription medications. Make sure you, your family, caregivers or anyone who spends time with you knows how to recognize an opioid overdose and how to use the naloxone. You and your family will be shown how to use medication by your doctor or pharmacist. You can ask your pharmacist or go to the manufacturer’s site for instructions. A friend or relative should administer the first dose of Naloxone if symptoms of overdose are present. They should also call 911 and remain with you until emergency medical assistance arrives. You may experience symptoms again within minutes of receiving naloxone. The person who administered the naloxone should administer another dose if your symptoms return. If symptoms return before help arrives, additional doses can be given every two to three minutes.

Overdose symptoms include:

• Having difficulty breathing
• Slow or shallow breathing
• Sleepiness or excessive drowsiness
• Unable to respond or awaken
• Loss of muscle tone
• Cold and clammy Skin
• fainting
• dizziness
• Slow heartbeat

What else should I know about the topic?

Attend all your appointments with the doctor and lab. Your doctor may order lab tests to determine your body’s reaction to codeine.

Tell your doctor or laboratory staff that you take codeine before undergoing any lab test, especially if the test involves methylene-blue.

Illegal to sell or give away this medication. It may cause harm or death to others. It’s possible that your prescription is not refillable. You can ask your pharmacist about refilling a prescription.

You should keep a list of all the medicines that you take, including those on prescription, non-prescription, and over-the-counter, along with any other products you may be taking such as vitamins, mineral supplements, or dietary supplements. This list should be brought with you to every doctor’s appointment or hospital admission. This information is important to have on hand in the event of an emergency.