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Codeine: Codeine is readily absorbed from the gastrointestinal tract. It is rapidly distributed from the intravascular spaces to the various body tissues, with preferential uptake by parenchymatous organs such as the liver, spleen and kidney. Codeine crosses the blood-brain barrier, and is found in fetal tissue and breast milk. The plasma concentration does not correlate with brain concentration or relief of pain; however, codeine is not bound to plasma proteins and does not accumulate in body tissues.
Treatment: A single or multiple overdose with acetaminophen and codeine is a potentially lethal polydrug overdose, and consultation with a regional poison control center is recommended.
Signs and Symptoms:
Codeine: Toxicity from codeine poisoning includes the opioid triad of: pinpoint pupils, depression of respiration, and loss of consciousness. Convulsions may occur.
WHY is this drug prescribed?
Codeine is used, usually in combination with other medications, to reduce
coughing that does not produce sputum or mucus. It is also used for relief
of mild to moderate pain. When used for pain, codeine is usually used with
aspirin and sometimes caffeine.

WHEN should it be used?
Codeine is usually taken every four to six hours as needed. Follow the
directions on your prescription label carefully, and ask your pharmacist
or doctor to explain any part that you do not understand.

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HOW should it be used?
Codeine is available, alone or with other medications, in tablets,
capsules, and liquid to be taken by mouth. Your prescription label tells
you how much to take at each dose. The liquid should be shaken well before
each use to mix the medicine evenly. Ask your pharmacist for a specially
marked measuring spoon to be sure of an accurate dose. Do not take more of
this drug than prescribed by your doctor. Serious side effects can occur,
especially in children who take too much. Adults giving this medication to
a child should be careful to give the correct dose and not to give it more
often than prescribed by the doctor. For a cough, patients older than 12
years should not take more than 120 mg of codeine a day. Children six to
12 years old should not take more than 60 mg a day. A doctor should decide
how much codeine can be taken by a child two to five years old. This drug
should not be given to children younger than two years.

Abuse and Dependence: Codeine can produce drug dependence of the morphine type and, therefore, has the potential for being abused. Psychological dependence, physical dependence, and tolerance may develop upon repeated administration and it should be prescribed and administered with the same degree of caution appropriate to the use of other oral narcotic medications. Codeine may impair mental and/or physical abilities required for the performance of potentially hazardous tasks such as driving a car or operating machinery. Such tasks should be avoided while taking this product. Alcohol and other CNS depressants may produce an additive CNS depression, when taken with this combination product, and should be avoided. Codeine may be habit-forming. Patients should take the drug only for as long as it is prescribed, in the amounts prescribed, and no more frequently than prescribed.
What SPECIAL INSTRUCTIONS should I follow while using this drug?
Codeine can be habit-forming. Do not take it more often or for a longer
time than your doctor tells you to, and do not take more than the amount
prescribed at each dose. If you think that you need more to relieve your
symptoms, call your doctor. Codeine makes some people drowsy. Do not drive
a car or operate dangerous machinery until you know how it affects you.

Do not drink alcohol while taking this medication. Alcohol can add to the
drowsiness caused by codeine.

What SIDE EFFECTS can this drug cause? What can I do about them?
Although side effects from codeine are not common, they can occur.

Drowsiness, dizziness, fainting. Lie down for a while. Get up slowly. If
these effects continue or are severe, call your doctor. Nausea, vomiting,
dry mouth, constipation. Take codeine with food or milk. Eat foods high in
fiber, and drink plenty of fluids. If these effects continue or are
severe, call your doctor. Chest pain, slow or difficult breathing. Stop
taking the drug and call your doctor at once. Hallucinations, slow or
rapid heartbeat, severe sedation, seizures. Stop taking the drug and call
your local poison control center immediately. These effects indicate that
you probably have taken


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