Weak opioid

Codeine

Codeine phosphate

Codeine is a weaker opioid used for mild to moderate pain and for cough. On its own it is prescription-only; low-dose tablets combined with paracetamol or ibuprofen can be bought from a pharmacy after a pharmacist's assessment.

Class B controlled drugSchedule 2 as a prescription medicine; Schedule 5 in low-dose combinationsPrescription only (low-dose combinations available over the counter)

How this medicine is supplied

Prescription only (low-dose combinations available over the counter) in the UK. Dispensed by us only against a valid prescription from a UK prescriber.

How prescriptions work

If someone becomes very drowsy, difficult to wake or is breathing slowly after taking codeine, call 999.

What it is used for

Mild to moderate pain, such as headache, dental pain or musculoskeletal pain
Pain not controlled by paracetamol or ibuprofen alone
Short-term relief of a dry, painful cough

How it works

Codeine itself is largely inactive. The body converts it into morphine in the liver, and that morphine produces the pain relief. How much is converted varies a lot between people, which is why codeine works well for some and hardly at all for others.

Forms available in the UK

Tablets and syrup (prescription)
Combination tablets with paracetamol (co-codamol)
Combination tablets with ibuprofen

Safety information you must know

Do not use codeine for more than three days in a row for pain without advice. Regular use can cause dependence and medication-overuse headaches.
Never take two products containing paracetamol together — check every label for the total daily paracetamol dose.
Codeine is not recommended for children under 12 and must not be used after tonsil or adenoid removal in under-18s.
Speak to a pharmacist before using codeine while breastfeeding — some mothers convert it very quickly and the baby can become dangerously drowsy.
Avoid alcohol, and do not drive if you feel drowsy.

Common side effects

Constipation
Drowsiness
Nausea
Dizziness
Dry mouth
Dependence and withdrawal headaches with regular use

Interactions to be aware of

Alcohol
Other opioids
Sedating antihistamines and sleeping tablets
Some antidepressants
Medicines that slow the bowels

UK legal position

Codeine is a Class B controlled drug. Low-dose combination products (8mg or less per unit) are Schedule 5 and available over the counter subject to a pharmacist's assessment; single-ingredient and higher-strength products are Schedule 2 prescription-only medicines.

Brand names you may see

Codeine phosphateCo-codamolSolpadeineNurofen Plus

Brand names are listed for identification only. We do not endorse or supply them.

This page provides general information only and does not constitute medical advice, a prescription or an offer to supply. Doses are decided by your prescriber. If you think you may need this medicine, speak to your GP, an NHS 111 clinician or a specialist pain service. In an emergency, call 999.