Codeine or 3-methylmorphine (a natural isomer of
methylated morphine, the other being the semi-synthetic 6-methylmorphine) is an opiate used for its analgesic, antitussive, antidiarrheal, antihypertensive, antianxiety, sedative and hypnotic properties, to suppress
premature labor contractions,myocardial infarction,
relief of skin irritation from itching, as well as many other uses.
Codeine is the second-most predominant alkaloid in opium, at up to three percent; it is much
more prevalent in the Iranian poppy (Papaver bracteatum),
and codeine is extracted from this species in some places although the
below-mentioned morphine methylation process is still much more common. It is
considered the prototype of the weak to midrangeopioids (tramadol,
dextropropoxyphene, dihydrocodeine, hydrocodone, oxycodone).
Codeine is marketed as both
a single-ingredient drug and in combination preparations with paracetamol (as co-codamol, e.g. brands Paracod,
Panadeine, Paramol, and the Tylenol with codeine series including Tylenol 3 and 4); with aspirin (as co-codaprin); or with ibuprofen (as Nurofen Plus). These combinations provide
greater pain relief than either agent alone (drug synergy). Codeine is also commonly marketed in products
containing codeine with other pain killers or muscle relaxers, as well as
codeine mixed with phenacetin (Emprazil With Codeine No. 1, 2, 3,
and 4), naproxen,indomethacin, diclofenac and others as well as more complex
mixtures including such mixtures as aspirin + paracetamol + codeine ± caffeine
± antihistamines and other agents such as those mentioned above.
Codeine-only products can be
obtained with a prescription as a time release tablet (e.g., Codeine Contin
100 mg and Perduretas 50 mg). Codeine is also marketed in cough
syrups with zero to a half-dozen other active ingredients, and a linctus (e.g.,
Paveral) for all of the uses for which codeine is indicated.
Injectable codeine is
available for subcutaneous or intramuscular injection; intravenous injection
can cause a serious reaction that can progress to anaphylaxis. Codeine suppositories are
also marketed in some countries