Chemically, codeine sulfate is morphinan-6-ol,7,8-didehydro-4,5-epoxy-3-methoxy-17-methyl- (5α,6α)-, sulfate (2:1) (salt), trihydrate. Codeine sulfate trihydrate is a fine, white, crystalline powder which is soluble in water and insoluble in chloroform and ether.
Codeine sulfate is an opioid analgesic indicated for the management of mild to moderately severe pain where the use of an opioid analgesic is appropriate.
Media Articles Related to Codeine
AAP: Stop Giving Codeine to Children
Source: Medscape Anesthesiology Headlines [2016.09.19]
The American Academy of Pediatrics urges parents and healthcare providers to stop giving codeine to children and calls for formal restrictions on its use.
Medscape Medical News
AAP: Say No to Codeine -- Period
Source: MedPage Today Neurology [2016.09.19]
(MedPage Today) -- Drug is riskier than alternatives and no more effective
Codeine Not Safe for Kids, Pediatricians Warn
Source: MedicineNet Chronic Cough Specialty [2016.09.19]
Title: Codeine Not Safe for Kids, Pediatricians Warn
Category: Health News
Created: 9/19/2016 12:00:00 AM
Last Editorial Review: 9/19/2016 12:00:00 AM
New Moms' Codeine Use Down Since Health Warnings
Source: MedicineNet Episiotomy Specialty [2015.05.13]
Title: New Moms' Codeine Use Down Since Health Warnings
Category: Health News
Created: 5/12/2015 12:00:00 AM
Last Editorial Review: 5/13/2015 12:00:00 AM
American Academy of Pain Management Gets a New Name
Source: Medscape Anesthesiology Headlines [2016.09.22]
The American Academy of Pain Management has now become the Academy of Integrative Pain Management, to better reflect the direction pain medicine is taking.
Medscape Medical News
Published Studies Related to Codeine
Single dose oral ibuprofen plus codeine for acute postoperative pain in adults. 
CONCLUSIONS: The combination of ibuprofen 400 mg plus codeine 25.6 mg to
Randomized clinical trial of hydrocodone/acetaminophen versus
codeine/acetaminophen in the treatment of acute extremity pain after emergency
department discharge. 
(DEA) Schedule III narcotics... CONCLUSIONS: Both medications decreased NRS pain scores by approximately 50%.
A randomized controlled trial comparing acetaminophen, acetaminophen and ibuprofen, and acetaminophen and codeine for postoperative pain relief after Mohs surgery and cutaneous reconstruction. [2011.07]
BACKGROUND: There are no population-based data comparing analgesics after Mohs micrographic surgery (MMS) and reconstruction. OBJECTIVE To compare the efficacy in pain management of three analgesic combinations... CONCLUSIONS: The combination of Ac+Ib is superior to Ac alone or Ac+Co in controlling postoperative pain after MMS and cutaneous reconstruction. (c) 2011 by the American Society for Dermatologic Surgery, Inc.
Analgesia with paracetamol/tramadol vs. paracetamol/codeine in one day-surgery: a randomized open study. [2011.02]
OBJECTIVES: The analgesic efficacy of two fixed combinations of tramadol/paracetamol (TP 37.5/325 mg) and codeine/paracetamol (CP 30/500 mg) was compared in 122 patients undergoing one-day surgical procedures (hallux valgus, haemorrhoidectomy, varicectomy and inguinal hernia repair), randomly treated with TP 37.5/325 mg or CP 30/500 mg one tablet after surgery ended, followed by one tablet four times daily for 48 hours... CONCLUSIONS: We conclude that a fixed association of tramadol/paracetamol is a valuable and safe tool for pain management in day hospital surgery, especially whenever any effort is done to reduce the time for hospitalization.
Influence of codeine on lobeline-induced respiratory reflexes and sensations and on ventilation with exercise in healthy subjects. [2011.01.31]
In 15 healthy subjects, the effect of 60 mg oral codeine and placebo was examined on intravenously injected lobeline-elicited respiratory reflexes and sensations. Its influence was also studied on ventilation and appearance of distressful respiratory sensations with modest but incremental exercise.It also suggests that codeine decreased these receptors' known contribution to respiratory augmentation and motor inhibition during exercise, which was seen as a delay in the onset of, and a decrease in the magnitude of respiratory discomfort during treadmill walking and an increase in the duration walked by more than half the subjects.
Clinical Trials Related to Codeine
Comparison of the Efficacy of Oral Oxycodone and Oral Codeine in the Treatment of Postcraniotomy Pain [Completed]
The efficacy of codeine is dependent on its demethylation to morphine. This extent of
demethylation has wide inter-individual variability, making codeine's efficacy as a
analgesic variable. Oxycodone is a semi-synthetic opioid and is a weak agonist on mu opioid
Codeine has been the mainstay of analgesia for patients after craniotomy for many years.
Traditionally, craniotomies were not thought to be very painful procedures, hence the use of
codeine, a moderately potent opioid (when compared to morphine).
However, in recent years, it has been found that up to 70% of post-craniotomy patients have
moderate to severe pain and codeine did not provide adequate analgesic relief. Many studies
have compared codeine to other drugs such as PCA morphine, fentanyl and tramadol, and
patients on these stronger opioids generally had lower pain scores and better satisfaction.
No study has been conducted to determine the efficacy of analgesia of oral oxycodone to oral
Hence, the hypothesis is that oxycodone is more effective than codeine in providing pain
relief in post-craniotomy patients.
A Comparison of Postoperative Tramadol Versus Acetaminophen With Codeine in Children Undergoing Tonsillectomy [Completed]
Tonsillectomy is the most common pediatric surgical procedure performed in the US. The
postoperative period can be particularly painful. Codeine (usually in mixed formulation with
acetaminophen) is the most commonly prescribed opioid in the US. However, evolving data
questions its ability to provide optimal pain relief, while avoiding side effects,
especially in the postoperative setting. Tramadol may be a better option for children in the
postoperative setting due to its well-documented analgesic properties, low potential for
side effects, and excellent safety profile. Seventy-two children scheduled to undergo
tonsillectomy (with or without adenoidectomy) at Children's will be invited to participate
in a randomized, prospective, double-blinded study to evaluate the efficacy and side effects
of codeine with acetaminophen versus tramadol. Using a 10-day take-home diary, caregivers
will be asked to record daily information about their child's postoperative pain and other
core outcomes and domains as recommended in the recent consensus statement put forth by the
Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials
(IMMPACT) (McGrath et al., 2008). This study will offer new information regarding the
efficacy and side effects associated with tramadol as compared with codeine/acetaminophen
(the current practice standard) in a pediatric population.
H1: Children who receive scheduled tramadol following tonsillectomy will report better pain
control than children who receive scheduled codeine/acetaminophen.
H2: Children who receive scheduled tramadol following tonsillectomy will report fewer side
effects than children who receive scheduled codeine/acetaminophen.
Analgesic Effect of Ibuprofen, Paracetamol (Acetaminophen), and Paracetamol (Acetaminophen) Plus Codeine on Acute Pain [Completed]
The purpose of this placebo controlled clinical trial is to evaluate the dose response
relationship of ibuprofen in doses from 400 mg to 800 mg and paracetamol (acetaminophen)in
doses from 500 mg to 1000 mg compared with paracetamol (acetaminophen)1000 mg plus codeine
60 mg on acute postoperative pain after surgical removal of impacted third molars.
Analgesic Effect of Paracetamol, Paracetamol + Codeine, Ibuprofen and Their Combination [Recruiting]
The purpose of this study is to determine whether the combination of paracetamol
(acetaminophen) and other NSAIDs with or without weak opioids can give synergistic analgesic
Naproxen Codeine in Arthroscopic Surgery [Completed]
Reports of Suspected Codeine Side Effects
Drug Hypersensitivity (71),
Toxicity TO Various Agents (14),
Abdominal Distension (11),
Drug Abuse (10),
Cardio-Respiratory Arrest (10),
Completed Suicide (9),
Dyspnoea (9), more >>