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<meta name="robots" content="INDEX,FOLLOW,NOARCHIVE" /><meta name="citation_inbook_title" content="LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]" /><meta name="citation_title" content="Codeine" /><meta name="citation_publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="citation_date" content="2019/04/25" /><meta name="citation_pmid" content="31643680" /><meta name="citation_fulltext_html_url" content="https://www.ncbi.nlm.nih.gov/books/NBK548359/" /><link rel="schema.DC" href="http://purl.org/DC/elements/1.0/" /><meta name="DC.Title" content="Codeine" /><meta name="DC.Type" content="Text" /><meta name="DC.Publisher" content="National Institute of Diabetes and Digestive and Kidney Diseases" /><meta name="DC.Date" content="2019/04/25" /><meta name="DC.Identifier" content="https://www.ncbi.nlm.nih.gov/books/NBK548359/" /><meta name="description" content="Codeine is one of the natural plant alkaloids found in extracts of opium and is commonly used to treat mild-to-moderate pain and cough. Codeine, like other opioids, has not been linked to serum enzyme elevations during therapy or to clinically apparent liver injury." /><meta name="og:title" content="Codeine" /><meta name="og:type" content="book" /><meta name="og:description" content="Codeine is one of the natural plant alkaloids found in extracts of opium and is commonly used to treat mild-to-moderate pain and cough. Codeine, like other opioids, has not been linked to serum enzyme elevations during therapy or to clinically apparent liver injury." /><meta name="og:url" content="https://www.ncbi.nlm.nih.gov/books/NBK548359/" /><meta name="og:site_name" content="NCBI Bookshelf" /><meta name="og:image" content="https://www.ncbi.nlm.nih.gov/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" /><meta name="twitter:card" content="summary" /><meta name="twitter:site" content="@ncbibooks" /><meta name="bk-non-canon-loc" content="/books/n/livertox/Codeine/" /><link rel="canonical" href="https://www.ncbi.nlm.nih.gov/books/NBK548359/" /><link rel="stylesheet" href="/corehtml/pmc/css/figpopup.css" type="text/css" media="screen" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books.min.css" type="text/css" /><link rel="stylesheet" href="/corehtml/pmc/css/bookshelf/2.26/css/books_print.min.css" type="text/css" media="print" /><style type="text/css">p a.figpopup{display:inline !important} .bk_tt {font-family: monospace} .first-line-outdent .bk_ref {display: inline} .body-content h2, .body-content .h2 {border-bottom: 1px solid #97B0C8} .body-content h2.inline {border-bottom: none} a.page-toc-label , .jig-ncbismoothscroll a {text-decoration:none;border:0 !important} .temp-labeled-list .graphic {display:inline-block !important} .temp-labeled-list img{width:100%}</style><script type="text/javascript" src="/corehtml/pmc/js/jquery.hoverIntent.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/common.min.js?_=3.18"> </script><script type="text/javascript" src="/corehtml/pmc/js/large-obj-scrollbars.min.js"> </script><script type="text/javascript">window.name="mainwindow";</script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/book-toc.min.js"> </script><script type="text/javascript" src="/corehtml/pmc/js/bookshelf/2.26/books.min.js"> </script><meta name="book-collection" content="NONE" />
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<div class="pre-content"><div><div class="bk_prnt"><p class="small">NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.</p><p>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. </p></div><div class="iconblock clearfix whole_rhythm no_top_margin bk_noprnt"><a class="img_link icnblk_img" title="All Drug Records" href="/books/n/livertox/"><img class="source-thumb" src="/corehtml/pmc/pmcgifs/bookshelf/thumbs/th-livertox-lrg.png" alt="Cover of LiverTox" height="100px" width="80px" /></a><div class="icnblk_cntnt eight_col"><h2>LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet].</h2><a data-jig="ncbitoggler" href="#__NBK548359_dtls__">Show details</a><div style="display:none" class="ui-widget" id="__NBK548359_dtls__"><div>Bethesda (MD): <a href="https://www.niddk.nih.gov/" ref="pagearea=page-banner&targetsite=external&targetcat=link&targettype=publisher">National Institute of Diabetes and Digestive and Kidney Diseases</a>; 2012-.</div></div><div class="half_rhythm"><ul class="inline_list"><li style="margin-right:1em"><a class="bk_cntns" href="/books/n/livertox/">Drug Records</a></li></ul></div><div class="bk_noprnt"><form method="get" action="/books/n/livertox/" id="bk_srch"><div class="bk_search"><label for="bk_term" class="offscreen_noflow">Search term</label><input type="text" title="Search this book" id="bk_term" name="term" value="" data-jig="ncbiclearbutton" /> <input type="submit" class="jig-ncbibutton" value="Search this book" submit="false" style="padding: 0.1em 0.4em;" /></div></form></div></div><div class="icnblk_cntnt two_col"><div class="pagination bk_noprnt"><a class="active page_link prev" href="/books/n/livertox/Cocaine/" title="Previous page in this title">< Prev</a><a class="active page_link next" href="/books/n/livertox/CoQ10/" title="Next page in this title">Next ></a></div></div></div></div></div>
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<div class="main-content lit-style" itemscope="itemscope" itemtype="http://schema.org/CreativeWork"><div class="meta-content fm-sec"><h1 id="_NBK548359_"><span class="title" itemprop="name">Codeine</span></h1><p class="small">Last Update: <span itemprop="dateModified">April 25, 2019</span>.</p></div><div class="body-content whole_rhythm" itemprop="text"><div id="Codeine.OVERVIEW"><h2 id="_Codeine_OVERVIEW_">OVERVIEW</h2><div id="Codeine.Introduction"><h3>Introduction</h3><p>Codeine is one of the natural plant alkaloids found in extracts of opium and is commonly used to treat mild-to-moderate pain and cough. Codeine, like other opioids, has not been linked to serum enzyme elevations during therapy or to clinically apparent liver injury.</p></div><div id="Codeine.Background"><h3>Background</h3><p>Codeine (koe’ deen) is a natural alkaloid derived from resin extracts from the seeds of the opium poppy, Papaver somniferum. Codeine has opiate-like analgesic effects, but is much less potent than morphine. Codeine, however, is well absorbed orally and is less likely to cause serious respiratory depression than morphine. Codeine has been used in clinical medicine for more than a century and is currently approved for use in the United States as an oral analgesic for mild-to-moderate pain and, in low doses, as an antitussive for suppression of nonproductive cough. Codeine is available in multiple formulations including oral tablets of 15, 30 and 60 mg, as well as oral solutions and solutions for injection (subcutaneously, intramuscularly, intravenously) in varying concentrations. The typical adult, oral dose of codeine for analgesia is 15 to 60 mg every 4 to 6 hours. In addition, multiple commercial products combining codeine with acetaminophen for therapy of mild-to-moderate pain are available generically and under brand names such as Codrix and Codet. Side effects of codeine include sedation, respiratory depression, mental clouding, euphoria, agitation, constipation, abdominal bloating, nausea, vomiting and constipation. Codeine is a controlled substance and classified as a Schedule III drug, indicating that it has medical usefulness, but also a potential for physical and psychological dependency and abuse. Codeine is also available in low concentrations (~12 mg/tablet) in combination with antihistamines, antitussants or sympathomimetic agents for symptomatic therapy of upper respiratory infections and cough. These products are typically available over-the-counter without prescription.</p></div><div id="Codeine.Hepatotoxicity"><h3>Hepatotoxicity</h3><p>Despite wide use for many years, codeine has not been linked to serum enzyme elevations during therapy and there have been no convincing cases of idiosyncratic acute, clinically apparent liver injury attributed to its use.</p><p>Liklihood score: E (unlikely cause of clinically apparent liver injury).</p><p>References on the safety and potential hepatotoxicity of codeine are given in the Overview section of the Opioids.</p><p>Drug Class: <a href="/books/n/livertox/Opioids/">Opioids</a></p></div></div><div id="Codeine.PRODUCT_INFORMATION"><h2 id="_Codeine_PRODUCT_INFORMATION_">PRODUCT INFORMATION</h2><div id="Codeine.BPI" class="box"><p>
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<b>REPRESENTATIVE TRADE NAMES</b>
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</p><p>Codeine – Generic, Codrix®</p><p>
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<b>DRUG CLASS</b>
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</p><p>Opioids</p><p>
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<a href="https://dailymed.nlm.nih.gov/dailymed/search.cfm?labeltype=all&query=Codeine" ref="pagearea=body&targetsite=external&targetcat=link&targettype=uri">COMPLETE LABELING</a>
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</p><p>Product labeling at DailyMed, National Library of Medicine, NIH</p></div></div><div id="Codeine.CHEMICAL_FORMULA_AND_STRUCTURE"><h2 id="_Codeine_CHEMICAL_FORMULA_AND_STRUCTURE_">CHEMICAL FORMULA AND STRUCTURE</h2><div id="Codeine.T1" class="table"><p class="large-table-link" style="display:none"><span class="right"><a href="/books/NBK548359/table/Codeine.T1/?report=objectonly" target="object">View in own window</a></span></p><div class="large_tbl" id="__Codeine.T1_lrgtbl__"><table><thead><tr><th id="hd_h_Codeine.T1_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">DRUG</th><th id="hd_h_Codeine.T1_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">CAS REGISTRY NO.</th><th id="hd_h_Codeine.T1_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">MOLECULAR FORMULA</th><th id="hd_h_Codeine.T1_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">STRUCTURE</th></tr></thead><tbody><tr><td headers="hd_h_Codeine.T1_1_1_1_1" rowspan="1" colspan="1" style="vertical-align:top;">Codeine</td><td headers="hd_h_Codeine.T1_1_1_1_2" rowspan="1" colspan="1" style="vertical-align:top;">76-57-3</td><td headers="hd_h_Codeine.T1_1_1_1_3" rowspan="1" colspan="1" style="vertical-align:top;">C18-H21-N-O3</td><td headers="hd_h_Codeine.T1_1_1_1_4" rowspan="1" colspan="1" style="vertical-align:top;">
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<div xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance"></div><div class="portlet"><div class="portlet_head"><div class="portlet_title"><h3><span>Views</span></h3></div><a name="Shutter" sid="1" href="#" class="portlet_shutter" title="Show/hide content" remembercollapsed="true" pgsec_name="PDF_download" id="Shutter"></a></div><div class="portlet_content"><ul xmlns:np="http://ncbi.gov/portal/XSLT/namespace" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="simple-list"><li><a href="/books/NBK548359/?report=reader">PubReader</a></li><li><a href="/books/NBK548359/?report=printable">Print View</a></li><li><a data-jig="ncbidialog" href="#_ncbi_dlg_citbx_NBK548359" data-jigconfig="width:400,modal:true">Cite this Page</a><div id="_ncbi_dlg_citbx_NBK548359" style="display:none" title="Cite this Page"><div class="bk_tt">LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. 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<title>GitHub</title>
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