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Codeine is associated with significant risks, including the potential for abuse and addiction, which could result in overdose and death. It may also lead to severe and potentially fatal breathing issues. To minimize these risks, it is important to take the smallest effective dose for the shortest duration as prescribed by your doctor.

• Opioid Overdose Preparedness: Consider keeping naloxone on hand to counteract potential opioid overdose, and educate your family or household members about recognizing and responding to opioid overdose symptoms.

• Breathing Risks: The likelihood of severe breathing problems is heightened at the start of treatment, after dosage increases, or if an incorrect dose is taken. Combining codeine with alcohol or other sedatives can lead to serious, possibly fatal side effects.

• Drug Interactions: Other medications may interfere with codeine's elimination from your body, impacting its effectiveness. Ensure you understand how to properly use this medication and know which drugs to avoid.

• Emergency Symptoms: Seek immediate medical attention if you experience slow or shallow breathing, significant lightheadedness, severe drowsiness, dizziness, or difficulty waking up.

• Storage and Safety: Store codeine securely to prevent theft, misuse, or abuse. If someone accidentally ingests this medication, seek medical assistance immediately.

• Pediatric Use: Codeine is not recommended for children under 18, as they may be more susceptible to serious, and sometimes fatal, breathing issues, especially if they are obese, have respiratory problems, or have recently undergone certain surgeries like tonsil or adenoid removal.

Discuss with your healthcare provider to thoroughly understand the risks and benefits of using codeine.

Common side effects:

• nausea
• vomiting
• stomach upset
• gas
• shaking
• constipation
• dry mouth
• lightheadedness
• dizziness
• drowsiness
• trouble sleeping

Less common but important to monitor:

• interrupted breathing during sleep
• mood changes
• rapid or irregular heartbeat
• increased thirst or urination
• hearing changes
• easy bruising or bleeding
• heartburn
• difficulty swallowing
• dark urine
• yellowing of the eyes or skin
• signs of kidney or adrenal gland issues (changes in urination or unusual tiredness)

Serious side effects:

• fainting
• seizures
• black stools
• severe stomach pain
• coffee ground-like vomit
• trouble speaking
• weakness on one side of the body
• severe drowsiness
• confusion
• slow/shallow breathing
• severe allergic reaction (fever, swollen lymph nodes, rash, itching, swelling, severe dizziness, or trouble breathing)

Interactions with high risk of serious adverse effects and should be avoided:

• Clopidogrel
• Warfarin
• hydrocodone
• alcohol
• marijuana (cannabis)
• Zolpidem
• Cyclobenzaprine
• Ketoconazole
• Fluoxetine
• Carbamazepine

Interactions with moderate risk that may require dose adjustment, closer monitoring, or timing changes:

• Acetazolamide
• antacids
• penicillin
• Sulfamethoxazole
• Probenecid
• Darunavir
• dichlorphenamide
• Lithium
• 6-mercaptopurine
• Methotrexate
• methoxyflurane
• Mifepristone
• Naltrexone
• morphine
• Nalbuphine
• doxycycline
• estrogen
• metoprolol