Is Codeine a Narcotic? 20 Reasons to Never Use Cough Syrup with Codeine - Dr. Axe

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Is Codeine a Narcotic? 20 Reasons to Never Use Cough Syrup with Codeine


Is codeine a narcotic - Dr. Axe

Did you know that codeine is dangerous for your child? After reviewing adverse event reports for the past 50 years, the FDA concluded that prescription codeine and tramadol should not be given to children and adolescents. Upon their review, the agency found 64 cases of severe breathing problems, including 24 deaths, as a result of codeine in children and adolescents.

The FDA now warns that codeine should not be used for pain or cough in children under 12 years old. The agency also recommends that adolescents aged 12–18 years old who are obese or who have breathing problems should not use codeine. Also, mothers taking codeine should not breastfeed. (1)

What Is Codeine? Is Codeine a Narcotic?

You may be wondering, is codeine a narcotic? As an opioid pain reliever, codeine is considered a narcotic. It’s used to treat mild to moderately severe pain and is used as a cough suppressant. (2) In fact, according to World Health Organization, it’s the most widely used narcotic in the world. Codeine was originally discovered by French chemist Pierre Robiquet in 1832. “Codeine” takes its name from the head of the poppy plant.

In the past, opium was derived from poppies, using tar from opiate poppies to synthesize codeine, as well as morphine and other opioids. The FDA approved codeine in 1950. (3) As it became increasingly difficult to secure this product due to political unrest in Afghanistan, where the bulk of the narcotic poppy industry is located, scientists figured out how to synthesize codeine from coal tar in 1973. (4, 5)

Although considered the “least addictive and safest” of all the prescribed opiate, make no mistake — codeine is still addictive and easily abused. In fact, addiction to codeine results in withdrawal symptoms like other opiates and usually requires professional rehabilitation. (6)


Opioids bind with the pain receptors in the brain — this is how they relieve pain symptoms — and can create a sensation of euphoria, or a high. A person who abuses codeine to reach this high may move on to stronger, and even more dangerous, opioids, including hydrocodone, oxycodone or street drugs like heroin. It’s also possible that a person may abuse codeine and not know it as it is found in many prescription-only formulas, and some OTC medicines, under a variety of names, in tablet and liquid form (such as a codeine cough syrup, like codeine antitussive) including: (78, 9)

  • Fioricet with codeine, Phrenillin with caffeine and codeine
  • Cotabflu
  • Colrex compound
  • Tylenol with codeine #3, and others
  • Phenflu CD
  • Maxiflu CD
  • Florinal with codeine
  • Soma compound with codeine (for muscle pain)
  • Empirin with codeine
  • Nalex AC
  • M-End PE, Poly-Tussin AC
  • Mar-cof BP (also contains pseudoephedrine)
  • Notuss-NX
  • CapCof
  • T-Koff
  • Pediatuss

Codeine vs. Hydrocodone

Hydrocodone is another commonly prescribed opioid used to treat pain. While codeine is used for mild to moderate pain, hydrocodone is more potent and is prescribed for more severe pain. Both codeine and hydrocodone are available in immediate-release tablets; however, hydrocodone in this form must be taken with acetaminophen. In addition to immediate-release, hydrocodone is available in extended-release tablets.  A hydrocodone extended-release tablet is effective by itself — it doesn’t require taking acetaminophen with it. Both codeine and hydrocodone cause side effects.

Since they are both opioids, hydrocodone and codeine are both very effective at soothing pain. However, they are strong drugs and can be addictive. Do not share your prescription codeine or hydrocodone with someone else. Follow your doctor’s instructions carefully as there is potential for overdose and abuse, especially with hydrocodone.

Long-term use of either drug can cause dependency, which means you may experience temporary withdrawal symptoms if you stop taking these medications. The side effects of codeine are the same as other opiates and are stronger in children. Do not give extended-release hydrocodone to children, as it can be fatal. Make sure your prescription medicines are stored and locked in a cabinet that children can’t reach. (1011)

20 Reasons to Never Use Codeine, Including Side Effects

The list of side effects codeine causes is long, ranging from less severe to severe, common to rare. Keep this in mind — is it worth taking a medication like codeine if it can cause anything from severe constipation to addiction, or possibly even overdose and death?

Just consider your choice wisely before you or a loved one takes this prescription drug. Below are just a few of the many side effects that may occur from taking codeine, as well as some other reasons to steer clear of it: (12)

Some common side effects of codeine:
1. Drowsiness
2. Incomplete or infrequent bowel movements (constipation)
3. Inducing of a relaxed state (euphoria)
4. Stomach cramps

Some infrequent side effects of codeine:
5. Decreased lung function
6. Trouble breathing
7. Dry mouth
8. Excessive sweating
9. Hives
10. Itching

Some rare side effects of codeine:
11. Adrenal gland problems
12. Complete stopping of the heart
13. Seizures
14. Shock
15. Diarrhea

16. Overdose: Call 911 or get emergency help immediately if any overdose symptoms occur, including the following: (13)

  • Bluish lips or skin
  • Change in consciousness
  • Chest pain or discomfort
  • Loss of consciousness
  • No blood pressure or pulse
  • Severe sleepiness
  • Slow or irregular heartbeat

17. Drug interactions: 819 drugs (4882 brand and generic names) are known to interact with codeine. Of these there are: (14)

  • 206 major interactions (1210 brand and generic names)
  • 610 moderate interactions (3664 brand and generic names)
  • 3 minor interactions (8 brand and generic names)

18. Alcohol interaction: Combining alcohol with codeine can lead to drowsiness, dizziness, lightheadedness and, in severe cases, coma or death. (15)

19. Disease interactions: There are 16 known disease interactions with codeine, including: (16)

  • Liver disease
  • Renal dysfunction
  • Hypotension (low blood pressure)
  • Intracranial pressure
  • Respiratory depression

20. Dangerous to use while pregnant or breastfeeding (17)

Better Natural Alternatives for Sore Throat & Pain Relief

If you’re in pain or you have a sore throat, you may be wondering if there are any natural pain relief options. Luckily, the answer is yes. Read on below for a list of just a few of the many natural pain relief remedies you can try:


Pain relief:

Sore throat relief:

Final Thoughts

  • The FDA warns that codeine should not be used for pain or cough in children under 12 years old.
  • Codeine is an opioid pain reliever. It’s used to treat mild to moderately-severe pain and is used as a cough suppressant.
  • Is codeine a narcotic? Yes, it’s the most widely-used narcotic in the world and can be addictive and can lead to overdose or death if abused.
  • If you must use codeine, follow your doctor’s instructions carefully and do not share your medication with others.
  • Keep medications in a locked cabinet that children can’t reach.
  • There are many natural pain relievers available for pain and sore throat relief.

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