Codeine

At Codeine is a medicine that is primarily used to relieve pain.

What is codeine

Codeine is one of the opioids. In medicine, it is used in two areas, as a pain reliever and a medicine for coughing. Codeine is made from opium juice, so it's a natural compound. In contrast to earlier times, when codeine was still often prescribed for coughs, most doctors today have become quite cautious about it, as the risk of side effects is high.

Pharmacological effect

There are large genetic differences among the population when it comes to the effects of codeine as a medicine. For some people, codeine has hardly any effect due to its genetic properties, for others it is so strong that they should refrain from taking the drug.

Codeine has an analgesic effect in the body in different ways. About 10% of the healing effect can be explained by the formation of the active metabolite morphine, which takes place in the body through a demethylation process. More than 400 mg of codeine are no longer effective, since at a higher dose it is no longer possible to metabolize codeine in the body. With normal doses of codeine, about 10% of this substance is excreted unchanged via the kidneys. The remainder also leaves the organism via the kidneys in the form of codeine conjugates or morphine conjugates.

Medical application & use

In general, codeine works against pain as well as very well against coughs. Codeine-containing drugs are particularly often prescribed for dry coughs. In the case of COPD, the effect is questionable. Before methadone could be made, codeine was also often used as a helpful means of overcoming heroin addiction.

For moderate to severe pain, drugs containing codeine are still often prescribed in combination with other painkillers. These supplementary drugs include paracetamol, diclofenac and acetylsalicylic acid.

Codeine, when prescribed for dry coughs, is often given in liquid form. These can be drops or cough syrup that contain codeine. There are also codeine-containing drugs that are offered in the form of tablets or capsules. Codeine normally has a plasma half-life of 2 to 3 hours in many drugs and can be broken down by the body very quickly. But this is not the case with every codeine-containing drug. Codeine is also available in the form of prolonged-release drugs. In this case, binding to the cation exchanger codeine-poly (styrene, divinylbenzene) sulfonate takes place, which in turn leads to a much longer half-life of codeine in the body and thus contributes to a longer duration of action.

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Risks & side effects

Codeine is one of the drugs that many doctors only prescribe with great caution due to the frequent and sometimes very serious side effects. The side effects are not always life-threatening but rather harmless.

Some of the harmless side effects of codeine include constipation, nausea, vomiting, and fatigue. Codeine has often been particularly dangerous in infants and children. The active ingredient can be passed on to the baby in breast milk if the mother takes drugs containing codeine. Somnolence (sleepiness), lethargy and poor drinking have often occurred in breastfed infants when the mothers have been treated with codeine.

In the codeine treatment of children themselves, some very serious side effects have become known. Most of the time, it was respiratory depression. Codeine should therefore no longer be prescribed for children if possible.

In Germany, codeine falls under the Narcotics Act and is generally subject to prescription. It should normally only be given in low doses to non-drug or alcohol addicts.