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Home / Drugs / Starting with C / Codeine

An opioid analgesic related to morphine but with less potent analgesic properties and mild sedative effects. It also acts centrally to suppress cough. [PubChem]
Opiate Agonists
Analgesics, Opioid
Antitussive Agents
ManufacturersRoxane laboratories inc
PackagersActavis Group
Aidarex Pharmacuticals LLC
Amarin Pharmaceuticals
Amerisource Health Services Corp.
Amneal Pharmaceuticals
Apotheca Inc.
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Athlon Pharmaceuticals Inc.
Barr Pharmaceuticals
BASF Corp.
Blansett Pharmacal Co. Inc.
Blenheim Pharmacal
Breckenridge Pharmaceuticals
Bryant Ranch Prepack
C.O. Truxton Inc.
Cardinal Health
Carlisle Laboratories Inc.
Centurion Labs
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Cerovene Inc.
Comprehensive Consultant Services Inc.
Corepharma LLC
Coupler Enterprises Inc.
D.M. Graham Laboratories Inc.
DAVA Pharmaceuticals
Direct Dispensing Inc.
Dispensing Solutions
Diversified Healthcare Services Inc.
Eon Labs
Glenmark Generics Ltd.
Golden State Medical Supply Inc.
Great Southern Laboratories
H and H Laboratories
H.J. Harkins Co. Inc.
Heartland Repack Services LLC
Hi Tech Pharmacal Co. Inc.
Hospira Inc.
Innoviant Pharmacy Inc.
Ivax Pharmaceuticals
Janssen-Ortho Inc.
Jerome Stevens Pharmaceuticals Inc.
Kaiser Foundation Hospital
Keltman Pharmaceuticals Inc.
Lake Erie Medical and Surgical Supply
Lannett Co. Inc.
Lehigh Valley Technologies Inc.
Liberty Pharmaceuticals
Major Pharmaceuticals
Mallinckrodt Inc.
Mckesson Corp.
MCR American Pharmaceuticals Inc.
Medvantx Inc.
Mikart Inc.
Murfreesboro Pharmaceutical Nursing Supply
Mutual Pharmaceutical Co.
Nexgen Pharma Inc.
Novartis AG
Nucare Pharmaceuticals Inc.
Ortho-McNeil-Janssen Pharmaceuticals Inc.
Palmetto Pharmaceuticals Inc.
Patient First Corp.
PD-Rx Pharmaceuticals Inc.
Pharmaceutical Association
Pharmpak Inc.
Physicians Total Care Inc.
Poly Pharmaceuticals Inc.
Preferred Pharmaceuticals Inc.
Prepackage Specialists
Prepak Systems Inc.
Ranbaxy Laboratories
Rebel Distributors Corp.
Redpharm Drug
Remedy Repack
Roxane Labs
Sandhills Packaging Inc.
SJ Pharmaceuticals LLC
Southwood Pharmaceuticals
St Mary's Medical Park Pharmacy
Stanley Pharmaceuticals Ltd.
Stat Rx Usa
Talbert Medical Management Corp.
Teva Pharmaceutical Industries Ltd.
TG United Inc.
UDL Laboratories
United Research Laboratories Inc.
Va Cmop Dallas
Valeant Ltd.
Vascondor Inc.
Veratex Corp.
Vintage Pharmaceuticals Inc.
Watson Pharmaceuticals
West-Ward Pharmaceuticals
Wockhardt Ltd.
SynonymsCodeine anhydrous
Morphine monomethyl ether
Norcodeine, N-Methyl
Norcodine, N-Methyl


For treatment and management of pain (Systemic), also used as an Antidiarrheal and as a cough suppressant.


Codeine, an opiate agonist in the CNS, is similar to other phenanthrene derivatives such as morphine. Codeine, in combination with guaifenesin or iodinated glycerol, is used as a cough suppressant and, as a single agent or in combination with acetaminophen or other products, is used for pain control and as an antidiarrheal agent.

mechanism of action

Opiate receptors are coupled with G-protein receptors and function as both positive and negative regulators of synaptic transmission via G-proteins that activate effector proteins. Binding of the opiate stimulates the exchange of GTP for GDP on the G-protein complex. As the effector system is adenylate cyclase and cAMP located at the inner surface of the plasma membrane, opioids decrease intracellular cAMP by inhibiting adenylate cyclase. Subsequently, the release of nociceptive neurotransmitters such as substance P, GABA, dopamine, acetylcholine and noradrenaline is inhibited. Opioids also inhibit the release of vasopressin, somatostatin, insulin and glucagon. Codeine's analgesic activity is, most likely, due to its conversion to morphine. Opioids close N-type voltage-operated calcium channels (OP2-receptor agonist) and open calcium-dependent inwardly rectifying potassium channels (OP3 and OP1 receptor agonist). This results in hyperpolarization and reduced neuronal excitability.


Respiratory depression, sedation and miosis and common symptoms of overdose. Other symptoms include nausea, vomiting, skeletal muscle flaccidity, bradycardia, hypotension, and cool, clammy skin. Apnea and death may ensue.


Hepatic. Codeine is a prodrug, itself inactive, but demethylated to the active morphine by the liver enzyme CYP2D6.


Well absorbed following oral administration with a bioavailability of approximately 90%.

half life

2-4 hours

drug interactions

Cimetidine: Cimetidine may decrease the therapeutic effect of codeine by decreasing its metabolism to its active metabolite, morphine. Monitor for changes in the therapeutic effect of codeine if cimetidine is initiated, discontinued or dose changed.

Dihydroquinidine barbiturate: Quinidine decreases the analgesic effect of codeine

Quinidine: Quinidine decreases the analgesic effect of codeine

Quinidine barbiturate: Quinidine decreases the analgesic effect of codeine

Terbinafine: Terbinafine may decrease the efficacy of Codeine by inhibiting active metabolite production. Consider an alternate analgesic or monitor for effectiveness of Codeine.

Triprolidine: The CNS depressants, Triprolidine and Codeine, may increase adverse/toxic effects due to additivity. Monitor for increased CNS depressant effects during concomitant therapy.