Presentation
The cause of these reactions is discussed and a review of the literature on the parenteral use of codeine phosphate is presented. [ncbi.nlm.nih.gov]
Entire Body System
- Fatigue
However, once the initial, positive effects have worn off, Adderall abuse can produce many unwanted symptoms including: 4 Fatigue. Feelings of depression and lethargy. Increased anxiety. Cravings. [drugabuse.com]
[…] depression, coma, and confusion; therapy should not be administered within 14 days of taking MAOIs Cases of adrenal insufficiency reported with opioid use, more often following greater than one month of use; symptoms may include nausea, vomiting, anorexia, fatigue [reference.medscape.com]
Case Report A 62-year-old man with a history of chronic lymphocytic leukemia presented with a three-day history of fatigue, dyspnea, fever, and a cough. He had last received chemotherapy three months earlier. [doi.org]
- Unconsciousness
Rapper Lil’ Wayne was admitted to the intensive care unit in March 2013 with seizures and unconsciousness caused by extremely high levels of codeine. [addictioncenter.com]
At high doses and overdoses, opioid-induced respiratory depression can result in a shortness of breath, abnormal breathing patterns, semi-consciousness, or unconsciousness. [psychonautwiki.org]
A broader view of opioids reveals that they also can have profound effects on emotional pain—which is perhaps a frequent, if unconscious, reason for their non-medical use/abuse. [encyclopedia.com]
- Hypoxemia
Cough suppression may adversely affect patients with these conditions by promoting pooling of secretions, airway obstruction, secondary infection, and hypoxemia. [pediatrics.aappublications.org]
However, 1 clinical study proposed that repeated episodes of hypoxemia result in altered µ-opioid receptors and greater analgesic potency of opioids in this setting. 36 Three additional pediatric deaths related to codeine were reported in 2013. 37 These [doi.org]
Course
- Severe Clinical Course
Drug dosing error with drops: severe clinical course of codeine intoxication in twins. Eur J Pediatr 2009;168:819-24. Ciszkowski C, Madadi P, Phillips MS, Lauwers AE, Koren G. Codeine, ultrarapid-metabolism genotype, and postoperative death. [web.archive.org]
Gastrointestinal
- Nausea
Symptoms can include cravings, sweating, runny nose, sleeping problems, yawning, cramps, weakness, nausea, diarrhea, chills, vomiting and irritability. [web.archive.org]
However this can be accompanied by a range of adverse side effects including nausea, dizziness, itching and depression. [ginad.org]
[…] are: Dizziness Tiredness Confusion, difficulty concentrating Euphoria, restlessness Blurred vision Dry mouth Limbs feeling heavy or muscles feeling stiff Sweating Mild allergic rash, itching and hives Decreased heart rate, palpitations Stomach-ache, nausea [adf.org.au]
Common side effects include symptoms such as: Headache Nausea Weakness Anxiety Euphoria Itching Vomiting Dry mouth Constipation Depression Lack of sex drive Additionally, known side effects include dizziness and drowsiness, which can worsen with alcohol [opiates.com]
Gastrointestinal: Less likely to cause nausea and vomiting than morphine. Other: Hydrocodone is a weaker opioid than morphine but still a effective opioid with similar potency to oxycodone. [druglibrary.org]
- Vomiting
Symptoms can include cravings, sweating, runny nose, sleeping problems, yawning, cramps, weakness, nausea, diarrhea, chills, vomiting and irritability. [web.archive.org]
Withdrawal symptoms usually start within a few hours after the last dose and become strongest between 48 and 72 hours. 3 These symptoms can include: Cravings for codeine Dilated pupils Abdominal cramps, diarrhoea, nausea, vomiting Lack of appetite Runny [adf.org.au]
Common side effects include symptoms such as: Headache Nausea Weakness Anxiety Euphoria Itching Vomiting Dry mouth Constipation Depression Lack of sex drive Additionally, known side effects include dizziness and drowsiness, which can worsen with alcohol [opiates.com]
Gastrointestinal: Less likely to cause nausea and vomiting than morphine. Other: Hydrocodone is a weaker opioid than morphine but still a effective opioid with similar potency to oxycodone. [druglibrary.org]
Common codeine side effects include: feeling dizzy or drowsy; nausea, vomiting, stomach pain; constipation; sweating; or mild itching or rash. This is not a complete list of side effects and others may occur. [drugs.com]
- Constipation
Inability to pass urine Severe constipation and obstructed bowel Agitation Cold clammy skin with a bluish tinge Mental numbness Very slow, shallow breathing Hallucinations and sometimes seizures Coma and death 1 Long-term effects of codeine Regular use [adf.org.au]
Be sure to follow the directions carefully, because continuing constipation can lead to more serious problems. [mayoclinic.org]
The available evidence indicates that codeine is more effective against cancer pain than placebo, but with increased risk of nausea, vomiting, and constipation. [ncbi.nlm.nih.gov]
Other side effects with the use of Codeine include headache, nausea, weakness, anxiety, euphoria, itching, vomiting, dry mouth, constipation, depression and lack of sex drive. [web.archive.org]
- Abdominal Pain
We present 2 cases of acute abdominal pain secondary to oral codeine that resolved after the administration of intravenous naloxone. [ncbi.nlm.nih.gov]
Common adverse reactions: drowsiness, lightheadedness, dizziness, sedation, nausea and vomiting, euphoria, dysphoria, constipation, abdominal pain, pruritus, and rash. [www2.mallinckrodt.com]
The symptoms of codeine abuse include: Dizziness Inability to focus Abdominal pain Constipation Sedated appearance Itchy skin Vision Changes Fainting Codeine Side Effects These can include: Nausea and vomiting Drowsiness A headache Difficulty breathing [addictionresource.com]
pain and kidney and liver failure. [pharmaonline.tv]
- Epigastric Pain
We report the case of a 42-year-old man who suffered from epigastric pain 1 hour after taking a tablet containing amoxicillin plus clavulanic acid (500/125 mg) and another tablet containing acetaminophen plus codeine (500/30 mg) for a respiratory infection [ncbi.nlm.nih.gov]
Cardiovascular
- Hypotension
Adverse reactions ranging from tachycardia and cutaneous vasodilatation to severe hypotension and apnoea occurred in three children who were given codeine phosphate intravenously. [ncbi.nlm.nih.gov]
[…] including orthostatic hypotension and syncope in ambulatory patients; there is increased risk in patients whose ability to maintain blood pressure has already been compromised by a reduced blood volume or concurrent administration of certain CNS depressant [reference.medscape.com]
Skin
- Pruritus
Common adverse reactions: drowsiness, lightheadedness, dizziness, sedation, nausea and vomiting, euphoria, dysphoria, constipation, abdominal pain, pruritus, and rash. [www2.mallinckrodt.com]
[…] particularly in ambulatory patients not experiencing severe pain): lightheadedness, dizziness, sedation, nausea, vomiting, sweating. d e f When used at antitussive doses: nausea, vomiting, constipation (with repeated doses), dizziness, sedation, palpitation, pruritus [web.archive.org]
- Urticaria
Scarlatiniform rash and urticaria were observed twice in the same patient following codeine intake. This rare drug-induced eruption may lead to mis-diagnosis in patients taking mild analgesics containing codeine. [ncbi.nlm.nih.gov]
Significant - Monitor Closely Sort by : Adverse Effects >10% Constipation Drowsiness 1-10% Hypotension Tachycardia or bradycardia Confusion Dizziness False feeling of well being Headache Lightheadedness Malaise Paradoxical CNS stimulation Restlessness Rash, urticaria [web.archive.org]
[…] the athlete, there is a risk of positive result of doping control Side Effects: The side effects include: Allergy · Bronchospasm · Constipation · Rash · Erythema · Nausea, Drowsiness · Thrombocytopenia exceptional · Respiratory depression in type · Urticaria [macromass.com]
Psychiatrical
- Euphoria
Orgasm suppression Pupil constriction Cognitive euphoria - This particular substance can be considered as less intense in its cognitive euphoria when compared with that of morphine or diacetylmorphine (heroin) due to the upper limit of how much can be [psychonautwiki.org]
Although the euphoria is not as intense as that experienced with the stronger opiates, the euphoria can still be quite intense. [erowid.org]
[…] from combination tablets (OR = 16.79, 95% CI [8.67, 32.51]), obtaining codeine from friends, family, and acquaintances (OR = 3.98, 95% CI [1.82, 8.7]), use of illicit controlled drugs (OR = 34.99, 95% CI [8.39, 145.94]) and use of codeine to experience euphoria [ncbi.nlm.nih.gov]
Effects blurred vision, confusion, constipation, difficulty urinating, dizziness, dry mouth, euphoria, heart palpitations, hives, itching, nausea, sweating, tiredness, treat cold and flu, treat cough, treat diarrhoea, treat severe pain, treats mild pain [adf.org.au]
In the absence of pain, those same chemical changes can produce euphoria. Loosely translated from Greek, euphoria means "good feeling." Codeine is extracted from opium. [encyclopedia.com]
- Addictive Behavior
These methods address not only the patient’s physical addiction, but also any co-occurring conditions that may have attributed to the person’s addictive behaviors, such as depression or anxiety. [rehabs.com]
Neurologic
- Headache
“Many of our headache patients would take as an acute treatment for headache. [irishtimes.com]
He said codeine-containing drugs were not a problem when used to treat genuine pain such as in terminal illnesses, but the problem emerged when they were used for "headaches" or other common ailments. [iol.co.za]
She had been taking these medications for 20 years due to migraine headache. Serum toxicology and genotype analysis for cytochrome P450, UDP glucuronosyltransferase, and other metabolizing enzymes were measured. [ncbi.nlm.nih.gov]
- Somnolence
Vol. 24, Pg. 600, 1974. rabbit LD50 intravenous 34mg/kg (34mg/kg) BEHAVIORAL: SOMNOLENCE (GENERAL DEPRESSED ACTIVITY) Experientia. Vol. 18, Pg. 446, 1962. rat LD50 intraperitoneal 100mg/kg (100mg/kg) Arzneimittel-Forschung. Drug Research. [chem.nlm.nih.gov]
In other studies comparing drowsiness in breastfed babies whose mothers took codeine/acetaminophen compared to acetaminophen alone, the frequency of somnolence was higher in the codeine/acetaminophen-exposed group. [fda.gov]
In multiple-dose studies nausea, vomiting and constipation were common, with somnolence and dizziness frequent in the 21-day study. Withdrawal from the studies, where reported, was less than 10% except in two studies. [ncbi.nlm.nih.gov]
[…] toxicity, and advice should be given to stop giving the child codeine and to seek medical attention immediately if their child is showing these signs or symptoms Symptoms of codeine toxicity include: reduced levels of consciousness; lack of appetite; somnolence [gov.uk]
- Ataxia
Cardiovascular side effects, ataxia, and headache occurred equally between the groups. CONCLUSIONS: Both drugs had a wide array of reported side effects, but the overall incidence of serious outcomes was low. Copyright © 2016 Elsevier Inc. [ncbi.nlm.nih.gov]
Adverse Reactions and Overdosage The principal clinical manifestations of codeine toxicity are respiratory depression and obtundation. 14, 15 In children, antitussive dosages of 3 to 5 mg/kg/d have produced somnolence, ataxia, miosis, vomiting, rash, [pediatrics.aappublications.org]
Workup
Serum
- Testosterone Decreased
The circulatory concentration of total testosterone decreased significantly by 20% after 3 days' use of codeine (p = 0.0002) and an atypical ABP result was noted in one of the subjects. [ncbi.nlm.nih.gov]
Treatment
INTRODUCTION AND AIMS: Few studies have described those seeking treatment for codeine dependence. [ncbi.nlm.nih.gov]
Thirty patients were assessed (all white, age 40 + 12 years using 127 + 79 mg/day of codeine [mean + SD]), and 17 entered treatment. Eight patients remained in the study by treatment week 8. [doi.org]
Taking away well-established treatment options, insisted the AESGP, would make it more difficult to avoid antibiotics. [otctoolbox.com]
Prognosis
Abstract Co-occurring pain impairs depression's prognosis. [ncbi.nlm.nih.gov]
Etiology
The disease is divided into several categories based on the underlying etiology, with the drug-induced variant comprising a rising number of the total cases and being reported in association with an increasing number of medications. [ncbi.nlm.nih.gov]
Mortality and major morbidity after tonsillectomy: etiologic factors and strategies for prevention. Laryngoscope 2013. In press. [web.archive.org]
Historically, codeine was considered an optimal oral analgesic for the outpatient treatment of acute pain of various etiologies in children, partly because of the perception that it was a safe opioid analgesic with a wide therapeutic index and a limited [doi.org]
Epidemiology
Analysing drug residues in wastewater (wastewater analysis) to monitor the consumption of those drugs in the population has become a complementary method to epidemiological surveys. [ncbi.nlm.nih.gov]
According to the latest statistics from the South African Community Epidemiology Network on Drug Use (Sacendu), released in February this year, 2% or 225 patients at drug abuse treatment centres had reported the misuse of codeine-containing drugs with [iol.co.za]
Pathophysiology
The likely underlying pathophysiological mechanism is codeine-induced spasm of the sphincter of Oddi combined with sphincter of Oddi dysfunction related to a previous cholecystectomy. [ncbi.nlm.nih.gov]
Prevention
Our efforts represent an evidence-based, innovative medication safety strategy to prevent adverse drug events, which is a model for the use of pharmacogenetics to optimize drug therapy in specialized pediatric populations. [ncbi.nlm.nih.gov]
Use proper storage and disposal, to help prevent abuse. Take action by having frequent conversations with the teens and young adults in your life about the dangers of medicine abuse. Learn how. [medicineabuseproject.org]
In addition it is used as a narcotic substitute in addiction treatment because it prevents morphine abstinence syndrome. [web.archive.org]
This may help prevent worsening of your condition and reduce the possibility of withdrawal symptoms, such as abdominal or stomach cramps, anxiety, fever, nausea, runny nose, sweating, tremors, or trouble with sleeping. [mayoclinic.org]