Codeine phosphate for pain

This leaflet is about the use of codeine phosphate to reduce mild or moderate pain. This might be pain from an injury, after an operation or due to an illness.

Wait at least 4 hours between doses of codeine. Do not give other medicines that contain codeine.

This leaflet has been written specifically about the use of this medicine in children. The information may differ from that provided by the manufacturer. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of drug

Codeine phosphate (often referred to as codeine)

Why is it important for my child to take this medicine?

Codeine will help your child to feel less pain.

What is codeine available as?

white tablets (15 mg, 30 mg, 60 mg)
clear liquid medicine (25 mg in 5 mL) – this contains a small amount of sugar and ethanol (alcohol)
white suppositories (a range of strengths is available)

When should I give codeine?

If your child needs help with pain day and night for several days, give a dose of codeine every 6 hours to help stop the pain from coming back.
If your child has pain that comes and goes, give a dose of codeine when they first complain of pain. Wait at least 4 hours before giving another dose.
You must not give your child more than four doses of codeine in 24 hours, so you may have to wait up to 6 hours between doses.
Write down the time that you give each dose, to help you remember.

How much should I give?

Your doctor will work out the amount of codeine (the dose) that is right for your child. The dose will be shown on the medicine label.

It is important that you follow your doctor’s instructions about how much to give.

How should I give codeine?

Tablets should be swallowed with a glass of water, juice or similar. Your child should not chew the tablets.

Liquid medicine: Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.

Suppositories

Wash your hands with soap and hot water.
Unwrap the suppository.
Your child should be lying on his or her side or front.
Hold one buttock gently to one side so that you can see the back passage.
Hold the suppository with the flat end close to the back passage.
Use one finger to push the suppository gently into the back passage. It needs to go about in by about 2 cm.
Your child should stay lying down for about 15 minutes so that the suppository doesn’t come out.
Wash your hands again with soap and hot water.

If your child empties their bowels (does a poo) within 30 minutes of inserting a suppository, you will need to insert another one.

When should the medicine start working?

Your child should start to feel less pain about 30 minutes after taking codeine. It may take up to an hour for the codeine to work properly.

What if my child is sick (vomits)?

Tablets or medicine

If your child is sick less than 30 minutes after taking a dose of codeine, give them the same dose again.
If your child is sick more than 30 minutes after a dose, you do not need to give them another dose. Wait at least 4 hours before giving any more codeine.

Suppository

If your child is sick at any time, you do not need to give them another dose, as the suppository will still work.

What if I forget to give it?

If your child is in pain, give the missed dose as soon as you remember. You must then wait at least 4 hours before giving any more.

What if I give too much?

It can be dangerous to give too much codeine.

If you give an extra dose of codeine by mistake, wait at least 8 hours before giving any more.

The box on the next page lists some of the symptoms that your child may get if they have had too much codeine. However, your child may not show any of these symptoms. If there is any possibility that your child may have had too much codeine, contact your doctor or take your child to hospital straight away. Take the medicine with you, so that the doctor can see what has been taken.

If you see any of these, or you are at all worried that your child may have had too much codeine, contact your doctor or take your child to hospital.

The pupils of the eyes (the black circles in the centre) may be very small.
Your child may find it hard to breathe, or they may be breathing slowly.
Your child may feel faint.
They may be sleepy.
Their heart may race.

Are there any possible side-effects?

We use medicines to make our children feel better, but sometimes they cause effects that we don’t want (side-effects).

Side-effects that you must do something about

If your child shows any sign of having had too much codeine, as described in the box above, take them to hospital straight away.

Other side-effects that you need to know about

Your child may feel sick or be sick after taking codeine.
Your child may get constipation (have difficulty doing a poo). You can help by giving your child plenty to drink while they are taking codeine. Your doctor may also suggest that you give them a laxative – a medicine that will help them go to the toilet. It is important that your child doesn’t strain on the toilet.
Some children may feel sleepy, get a headache, have changes in mood, have nightmares or see strange things (hallucinations). Some children find that their eyesight is blurry or double. Your child may find it difficult to pass urine (do a wee). If your child has any of these symptoms, contact your doctor.

Can other common medicines be given at the same time as codeine?

Some painkillers and cough medicines contain codeine (you can find this information on the label). Do not give these to your child if you have given them codeine.
Do not give your child any medicine that contains morphine or dihydrocodeine.
You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.
Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal or complementary medicines.

Is there anything else I need to know about this medicine?

If your child has asthma or epilepsy, check with your doctor or pharmacist that you can give them codeine.
You may have heard that some people become addicted to or dependent on codeine. This is unlikely to happen when codeine is given to children in pain for short periods of time.
An antidote can be given to someone who has had too much codeine. This has to be done in hospital.

General advice

If the codeine does not seem to be helping your child’s pain, contact your doctor for advice.
Only give this medicine to your child. Never give it to anyone else, even if they seem to have the same condition, as you could do them harm.
If you think someone else may have taken codeine by accident, contact your doctor for advice. If they show any of the symptoms listed above, take them to hospital straight away.
Write down the times that you give codeine, to help you remember and to make sure that you don’t give too much.
Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.
Make sure that the medicine is not older than the ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

Keep all medicines where children cannot see or reach them.
Keep this medicine somewhere cool and dry, away from direct heat and light. It does not need to be kept in the fridge.
Keep the medicine in the container it came in.