Codeine Contin

Brand Names: Codeine Contin

Common Name: codeine controlled release

What is this drug used for?

This medication belongs to the class of medications known as narcotic analgesics (pain relievers). It is used to treat mild-to-moderate long-term (chronic) pain. It works by blocking pain signals in the brain.

Your doctor may have suggested this medication for conditions other than the ones listed in these drug information articles. If you have not discussed this with your doctor or are not sure why you are taking this medication, speak to your doctor. Do not stop taking this medication without consulting your doctor.

Do not give this medication to anyone else, even if they have the same symptoms as you do. It can be harmful for people to take this medication if their doctor has not prescribed it.

Is there any reason not to take this drug?

Codeine controlled release should not be taken by anyone who:

• is allergic to narcotic analgesics or to any of the ingredients of the medication
• has a head injury or increased pressure inside the head or spinal cord
• has acute alcoholism or delirium tremens
• has acute asthma or other obstructive airway disease
• has acute respiratory depression
• has convulsive (seizure) disorders
• has cor pulmonale
• has severe central nervous system (CNS) depression
• has surgical abdomen (a serious abdomen condition that usually requires surgery)
• has taken monoamine oxidase (MAO) inhibitors (e.g., phenelzine, tranylcypromine) within the past 14 days

What about possible side effects?

Many medications can cause side effects. A side effect is an unwanted response to a medication when it is taken in normal doses. Side effects can be mild or severe, temporary or permanent. The side effects listed below are not experienced by everyone who takes this medication. If you are concerned about side effects, discuss the risks and benefits of this medication with your doctor.

The following side effects have been reported by at least 1% of people taking this medication. Many of these side effects can be managed, and some may go away on their own over time.

Contact your doctor if you experience these side effects and they are severe or bothersome. Your pharmacist may be able to advise you on managing side effects.

• constipation
• dizziness, lightheadedness, or feeling faint
• drowsiness
• nausea or vomiting
• sweating
• itching
• headache
• dry mouth
• weakness

Although most of the side effects listed below don't happen very often, they could lead to serious problems if you do not seek medical attention.

Check with your doctor as soon as possible if any of the following side effects occur:

• depression or other mood or mental changes
• difficulty urinating
• fast, slow, or pounding heartbeat
• feelings of disassociation from reality
• hallucinations
• hives or skin rash
• redness or flushing of face
• trembling or uncontrolled muscle movements
• unusual excitement or restlessness (especially in children)

Stop taking the medication and seek immediate medical attention if any of the following occur:

• shortness of breath, wheezing, or difficulty breathing
• swelling of face
• symptoms of overdose such as cold, clammy skin, abnormally slow or weak breathing, severe dizziness, confusion, slow heartbeat, or extreme drowsiness

Some people may experience side effects other than those listed. Check with your doctor if you notice any symptom that worries you while you are taking this medication.

What if I am taking other drugs?

There may be an interaction between codeine controlled release and any of the following:

alcohol amphetamines anesthetics (e.g., nitrous oxide, halothane, thiopental) anticholinergic medications (e.g., benztropine, hyoscyamine) antihistamines that cause drowsiness (e.g., diphenhydramine) barbiturates (e.g., phenobarbital) beta-blockers (e.g., propranolol, metoprolol) butorphanol cimetidine glutethimide MAO inhibitors (e.g., selegiline, procarbazine, tranylcypromine) taken within the past 14 days

methocarbamol nalbuphine naltrexone other narcotic analgesics pentazocine phenothiazines (e.g., chlorpromazine, promethazine, perphenazine) quinidine sedatives (e.g., diazepam, chloral hydrate) thiopental tricyclic antidepressants (e.g., amitriptyline, imipramine) warfarin

If you are taking any of these medications, speak with your doctor or pharmacist. Depending on your specific circumstances, your doctor may want you to:

• stop taking one of the medications,
• change one of the medications to another,
• change how you are taking one or both of the medications, or
• leave everything as is.

An interaction between two medications does not always mean that you must stop taking one of them. Speak to your doctor about how any drug interactions are being managed or should be managed.

Medications other than those listed above may interact with this medication. Tell your doctor or prescriber about all prescription, over-the-counter (non-prescription), and herbal medications you are taking. Also tell them about any supplements you take. Since caffeine, alcohol, the nicotine from cigarettes, or street drugs can affect the action of many medications, you should let your prescriber know if you use them.

Other information:

Before you begin using a medication, be sure to inform your doctor of any medical conditions or allergies you may have, any medications you are taking, whether you are pregnant or breast-feeding, and any other significant facts about your health. These factors may affect how you should use this medication.

Constipation: Practically everyone becomes constipated while taking narcotic pain relievers on a regular basis. In some people, particularly the elderly or bedridden, fecal impaction may result. Appropriate bowel habits are very important. Your doctor will discuss the use of stimulant laxatives, stool softeners, and other measures to be used as required.

Dependence: As with other narcotics, this medication may become habit-forming if taken for long periods of time. Abuse is not a problem with people who require this medication for pain relief. Withdrawal symptoms may occur if codeine controlled release is stopped suddenly. Those on prolonged therapy should stop the medication gradually as discussed with their doctor if it is no longer required for pain control.

The following withdrawal symptoms may occur after narcotic analgesics are stopped suddenly:

• body aches
• diarrhea
• goosebumps
• loss of appetite
• nausea
• nervousness or restlessness
• racing heart
• runny nose
• sneezing
• stomach cramps
• tremors or shivering
• trouble sleeping
• unexplained fever
• unusual increase in sweating and yawning
• weakness

People who undergo gradual withdrawal from this medication usually have only mild symptoms.

Drowsiness/reduced alertness: Codeine may impair the mental or physical abilities needed for activities such as driving a car or operating machinery. Use caution if undertaking these types of activities.

Medical conditions: Debilitated people, or people with severely reduced kidney or liver function, Addison's disease, hypothyroidism, enlarged prostate, or urethral stricture may be more sensitive to the effects of codeine controlled release and may need lower doses.

Pregnancy: This medication should not be used during pregnancy unless the benefits outweigh the risks. If you become pregnant while taking this medication, contact your doctor immediately.

Breast-feeding: This medication passes into breast milk. If you are a breast-feeding mother and are taking codeine controlled release, it may affect your baby. Talk to your doctor about whether you should continue breast-feeding.

Seniors: Seniors may be more sensitive to the effects of this medication and may need lower doses.

Special Instructions:

The dose varies widely based on needs. Tablets should be taken every 12 hours in order to achieve pain relief. To preserve the long-acting activity of the medication, the tablets should be swallowed whole and should not be chewed or crushed. All tablet strengths, except the 50 mg tablets, may be halved. Half tablets should also be swallowed intact.

This medication may be habit-forming if taken for long periods of time. You may experience withdrawal effects if you stop taking this medication suddenly after extended use. If you plan on stopping the medication, the doctor may want you to reduce the dose gradually to reduce the severity of withdrawal effects.

Many things can affect the dose of medication that a person needs, such as body weight, other medical conditions, and other medications. If your doctor has recommended a dose different from the ones listed here, do not change the way that you are taking the medication without consulting your doctor.

It is important that this medication be taken exactly as prescribed by your doctor. If you miss a dose, take it as soon as possible and continue with your regular schedule. If it is almost time for your next dose, skip the missed dose and continue with your regular dosing schedule. Do not take a double dose to make up for a missed one.

Store this medication at room temperature and keep it out of the reach of children.

Do not dispose of medications in wastewater (e.g. down the sink or in the toilet) or in household garbage. Ask your pharmacist how to dispose of medications that are no longer needed or have expired.

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