Codeine Phosphate tablets BP 30 mg – patient leaflet, side effects, dosage

1 What Codeine Phosphate Tablets are and what they are used for

This medicine has been prescribed for you for the relief of mild to moderate pain, symptoms of a dry cough or diarrhoea. The tablets can be used on their own or in combination with other pain killers such as paracetamol. Codeine can be used in children over 12 years of age for the short-term relief of moderate pain that is not relieved by other pain killers such as paracetamol or ibuprofen alone.

It contains codeine which belongs to a class of medicines called opioids, which are ‘pain relievers’.

This medicine has been prescribed to you and should not be given to anyone else.

Opioids can cause addiction and you may get withdrawal symptoms if you stop taking it suddenly. Your doctor should have explained how long you will be taking it for, when it is appropriate to stop and how to do this safely.

2 What you need to know before you take Codeine Phosphate Tablets

Do not take Codeine Phosphate Tablets:

• if you are allergic to codeine or other opioids, or any of the other ingredients of this medicine (listed in section 6)
• if you have difficulty breathing, or other chronic lung disease
• if you have suffered head injury or raised pressure in the skull (may cause painful eyes, changes in vision or headache behind the eyes)
• if you are having an asthma attack
• if you have liver failure
• if you are at risk of blocked intestines
• if you suffer with alcoholism
• if you are under 12 years old
• for pain relief in children and adolescents (0-18 years of age) after removal of their tonsils or adenoids due to obstructive sleep apnoea syndrome
• if you know that you metabolise codeine very rapidly into morphine
• if you are breast-feeding.

Warnings and precautions

Talk to your doctor or pharmacist before taking Codeine Phosphate Tablets if you:

• have liver or kidney problems
• have diseased adrenal glands (Addison’s disease) or high blood pressure caused by a tumour near a kidney (phaeochromocytoma)
• have inflammatory bowel disease including severe bloody diarrhoea (pseudomembranous colitis)
• have gall bladder disease or gall stones
• have recently had surgery on your gastro-intestinal tract or urinary system
• have an enlarged prostate gland and have difficulty urinating and are male
• have epilepsy
• are elderly or frail
• suffer with asthma or breathing problems
• have an underactive thyroid gland
• have muscle weakness (myasthenia gravis)
• have low blood pressure or are in shock
• experience pain or increased sensitivity to pain (hyperalgesia) which does not respond to a higher dosage of your medicine
• are or have ever been addicted to opioids, alcohol, prescription medicines, or illegal drugs
• have previously suffered from withdrawal symptoms such as agitation, anxiety, shaking or sweating, when you have stopped taking alcohol or drugs.

Tolerance, dependence, and addiction

This medicine contains codeine which is an opioid medicine. It can cause dependence and/or addiction.

Repeated use of opioids can result in the drug being less effective (you become accustomed to it, known as tolerance). Repeated use of Codeine Phosphate Tablets can also lead to dependence, abuse and addiction, which may result in life-threatening overdose. The risk of these side effects can increase with a higher dose and longer duration of use.

Dependence or addiction can make you feel that you are no longer in control of how much medicine you need to take or how often you need to take it.

Please tell your doctor about all sedative medicines you are taking, and follow your doctor’s dose recommendation closely. It could be helpful to inform friends or relatives to be aware of the signs and symptoms stated above. Contact your doctor when experiencing such symptoms.

Codeine Phosphate Tablets with food, drink and alcohol

Do not drink alcohol while taking Codeine Phosphate Tablets.

Swallow the tablets with water.

Pregnancy and breast-feeding

Do not take Codeine Phosphate Tablets if you are pregnant or think you might be pregnant unless you have discussed this with your doctor and the benefits of treatment are considered to outweigh the potential harm to the baby.

If you use Codeine Phosphate Tablets during pregnancy, your baby may become dependent and experience withdrawal symptoms after the birth which may need to be treated.

Do not take Codeine Phosphate Tablets while you are breast-feeding as codeine passes into breast milk and will affect your baby. Some women who are at increased risk of developing side effects at any dose may have higher levels of codeine in their breast milk.

If any of the following side effects develop in you or your baby stop taking this medicine and seek immediate medical advice: feeling sick, being sick, constipation, poor appetite, feeling tired or sleeping for longer than normal, and shallow or slow breathing.

Driving and using machines

Codeine Phosphate Tablets may make you feel drowsy, confused or dizzy, cause fits, blurred or double vision or to see things that are not there. Make sure you are not affected before you drive or operate machinery.

The medicine can affect your ability to drive as it may make you sleepy or dizzy.

• Do not drive while taking this medicine until you know how it affects you.
• It is an offence to drive if this medicine affects your ability to drive.

• However, you would not be committing an offence if:

  • The medicine has been prescribed to treat a medical or dental problem and
  • You have taken it according to the instructions given by the prescriber or in the information provided with the medicine and
  • It was not affecting your ability to drive safely.

Talk to your doctor or pharmacist if you are not sure whether it is safe for you to drive while taking this medicine.

Codeine Phosphate Tablets contain Lactose

If you have been told by your doctor that you have an intolerance to some sugars, contact your doctor before taking this medicinal product.

3 How to take Codeine Phosphate Tablets

Always take this medicine exactly as your doctor or pharmacist has told you. Check with your doctor or pharmacist if you are not sure.

Before starting treatment and regularly during treatment, your doctor will discuss with you what you may expect from taking Codeine Phosphate Tablets, when and how long you need to take it, when to contact your doctor, and when you need to stop it

(see also, If you stop taking Codeine Phosphate Tablets). Do not drink alcohol whilst taking Codeine Phosphate Tablets. Swallow the tablets with water.

Codeine Phosphate Tablets are normally used only for short-term relief of symptoms, take this medicine for as long as your doctor tells you to, it may be dangerous to stop without their advice. Codeine Phosphate Tablets should be used for the shortest duration necessary to relieve symptoms.

Doses:

Adults:

For pain relief – 30 - 60mg every four hours up to a maximum of 240mg a day.

For diarrhoea – 15 - 60mg three to four times a day.

For cough – 15 - 30mg three to four times a day.

Elderly patients with liver or kidney damage: Your doctor may give you a smaller dose. If you are elderly, it is particularly important to take this medicine exactly as directed by the doctor.

Use in children and adolescents:

Children aged 12 years or above:

For pain relief - 30 - 60mg every 6 hours, as needed. Do not take more than 240mg in 24 hours.

This medicine should not be taken for more than 3 days. If the pain does not improve after 3 days, talk to your doctor for advice.

Codeine Phosphate Tablets should not be used for pain relief in children aged 12 years or above after removal of tonsils or adenoids (see section 2 Warnings and Precautions). Talk to your doctor before taking this medicine if this applies to you.

For diarrhoea - 15 - 60mg three to four times a day.

For cough - 15 - 30mg three to four times a day. Codeine Phosphate Tablets are not recommended for treatment of cough in children aged 12 years or above if they have breathing problems. Talk to your doctor before taking this medicine if this applies to you.

Children under 12 years:

Codeine Phosphate Tablets are not recommended for use in children under 12 years. Codeine Phosphate Tablets must not be taken by children below the age of 12 years for treatment of cough, due to the risk of severe breathing problems.

If you take more Codeine Phosphate Tablets than you should

If you (or someone else) swallow a lot of tablets at the same time, or you think a child may have swallowed any, contact your nearest hospital casualty department or tell your doctor immediately. Symptoms of an overdose include feeling or being sick, drowsiness, tiredness, low blood pressure, pinpoint pupils, slow breathing rate, fast heart rate.

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If you forget to take Codeine Phosphate Tablets

Do not take a double dose to make up for a forgotten dose. If you forget to take a dose take it as soon as you remember it and then take the next dose at the right time.

If you stop taking Codeine Phosphate Tablets

Do not suddenly stop taking this medicine. If you want to stop taking this medicine, discuss this with your doctor first. They will tell you how to do this, usually by reducing the dose gradually so that any unpleasant withdrawal effects are kept to a minimum. Withdrawal symptoms such as restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, shaking, shivering or sweating may occur if you suddenly stop taking this medicine.

4 Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

Tell your doctor if you notice any of the following side effects or notice any other effects not listed:

• Allergic Reactions - skin rash or itchy skin, difficulty breathing, increased sweating, redness or flushed face
• Gastrointestinal system - constipation, feeling or being sick, dry mouth, abdominal pain (may be caused by spasm of the bile ducts)
• Hepatobiliary effects – Not known: Symptoms associated with inflammation of the pancreas (pancreatitis) and the biliary tract system (a problem affecting a valve in the intestines known as sphincter of Oddi dysfunction), e.g. severe upper abdominal pain possibly radiating to the back, nausea, vomiting or fever
• Heart - slow or fast heart rate, palpitations, low blood pressure, low blood pressure on standing
• Urinary system - pain and difficulty in passing urine and a less frequent need to do so
• Nervous system - drowsiness, malaise, tiredness, dizziness, ‘spinning’ sensation, fits, increased pressure in the skull (painful eyes, changes in vision or headache behind the eyes), headache, tolerance (medicine has less effect) or dependence (suffer from withdrawal symptoms if the medicine is stopped too quickly, see ‘Drug Withdrawal’)
• Psychiatric effects – unknown frequency: dependence and addiction (see section ‘How do I know if I am addicted?’), mood changes, depression, hallucinations (seeing or hearing things that are not real), restlessness, excitation, nightmares, confusion
• Eyes - blurred or double vision, extremely small pupils
• Others - muscle stiffness, decrease in sex drive, difficulty breathing, low body temperature.

Drug Withdrawal

When you stop taking Codeine Phosphate Tablets, you may experience drug withdrawal symptoms, which include restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, shaking, shivering or sweating.

How do I know if I am addicted?

If you notice any of the following signs whilst taking Codeine Phosphate Tablets, it could be a sign that you have become addicted.

• You need to take the medicine for longer than advised by your doctor.

  • You feel you need to use more than the recommended dose.
  • You are using the medicine for reasons other than prescribed.
  • When you stop taking the medicine you feel unwell, and you feel better once taking the medicine again. If you notice any of these signs, it is important you talk to your doctor.

Reporting of side effects

If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any possible side effects not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at:

www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.

5 How to store Codeine Phosphate Tablets

Keep out of the sight and reach of children. Store this medicine in a safe and secure storage space, where other people cannot access it. It can cause serious harm and be fatal to people when it has not been intended for them. Store below 25°C in a dry place, protected from light.

Do not take Codeine Phosphate Tablets after the expiry date stated on the label/carton/bottle. The expiry date refers to the last day of that month.

Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help to protect the environment.

6 Contents of the pack and other information

What Codeine Phosphate Tablets contain

• The active substance (the ingredient that makes the tablets work) is codeine phosphate hemihydrate. Each tablet contains either 15mg, 30mg or 60mg of the active ingredient.
• The other ingredients are lactose, magnesium stearate, pregelatinised maize starch, maize starch, stearic acid.

What Codeine Phosphate Tablets look like and contents of the pack

Codeine Phosphate 15mg Tablets are white, circular, biconvex uncoated tablets impressed “C” on one face and the identifying letters “CO” on the reverse.

Codeine Phosphate 30mg Tablets are white, circular, biconvex uncoated tablets impressed “C” on one face and the identifying letters “CR” on the reverse.

Codeine Phosphate 60mg Tablets are white, circular, biconvex uncoated tablets impressed “C” on one face and the identifying letters “CS” on the reverse.

Pack sizes are 28.

Marketing Authorisation Holder and Manufacturer

Accord, Barnstaple, EX32 8NS, UK.

This leaflet was last revised in March 2026.

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The risk of becoming dependent or addicted varies from person to person. You may have a greater risk of becoming dependent on or addicted to Codeine Phosphate Tablets if you:

• or anyone in your family have ever abused or been dependent on alcohol, prescription medicines or illegal drugs (“addiction”).
• are a smoker.
• have ever had problems with your mood (depression, anxiety, or a personality disorder) or have been treated by a psychiatrist for other mental illnesses.

If you notice any of the following signs whilst taking Codeine Phosphate Tablets, it could be a sign that you have become dependent or addicted:

• you need to take the medicine for longer than advised by your doctor
• you need to take more than the recommended dose
• you might feel that you need to carry on taking your medicine, even when it doesn’t help to relieve your pain or cough
• you are using the medicine for reasons other than prescribed, for instance, ‘to stay calm’ or ‘help you sleep’
• you have made repeated, unsuccessful attempts to quit or control the use of the medicine
• when you stop taking the medicine you feel unwell, and you feel better once taking the medicine again (‘withdrawal effects’).

If you notice any of these signs, speak to your doctor to discuss the best treatment pathway for you, including when it is appropriate to stop and how to stop safely (see section 3, If you stop taking Codeine Phosphate Tablets).

Codeine is transformed to morphine in the liver by an enzyme. Morphine is the substance that produces the effects of codeine and relieves pain and symptoms of cough. Some people have a variation of this enzyme and this can affect people in different ways. In some people, morphine is not produced or produced in very small quantities, and it will not provide enough pain relief or relieve their cough. Other people are more likely to get serious side effects because a very high amount of morphine is produced.

If you notice any of the following side effects, you must stop taking this medicine and seek immediate medical advice: slow or shallow breathing, confusion, sleepiness, small pupils, feeling or being sick, constipation, lack of appetite.

Addiction can cause withdrawal symptoms when you stop taking this medicine. Withdrawal symptoms can include restlessness, difficulty sleeping, irritability, agitation, anxiety, feeling your heartbeat (palpitations), increased blood pressure, feeling or being sick, diarrhoea, loss of appetite, shaking, shivering or sweating. Your doctor will discuss with you how to gradually reduce your dose before stopping the medicine. It is important that you do not stop taking the medicine suddenly as you will be more likely to experience withdrawal symptoms.

Opioids should only be used by those they are prescribed for. Do not give your medicine to anyone else.

Sleep-related breathing disorders

Codeine Phosphate Tablets can cause sleep-related breathing disorders such as sleep apnoea (breathing pauses during sleep) and sleep related hypoxemia (low oxygen level in the blood). The symptoms can include breathing pauses during sleep, night awakening due

to shortness of breath, difficulties to maintain sleep or excessive drowsiness during the day. If you or another person observe these symptoms, contact your doctor. A dose reduction may be considered by your doctor.

Contact your doctor if you experience severe upper abdominal pain possibly radiating to the back, nausea, vomiting or fever as this could be symptoms associated with inflammation of the pancreas (pancreatitis) and the biliary tract system.

Children and adolescents

• Use in children and adolescents after surgery: Codeine should not be used for pain relief in children and adolescents after removal of their tonsils or adenoids due to Obstructive Sleep Apnoea Syndrome.
• Use in children with breathing problems:

Codeine is not recommended in children with breathing problems, since the symptoms of morphine toxicity may be worse in these children.

• Adolescents older than 12 years of age:

Codeine is not recommended in adolescents with compromised respiratory function for the treatment of cough.

Other important warnings

• Do not take for longer than directed by your doctor.
• Taking a painkiller for headaches too often or for too long can make them worse.

Other medicines and Codeine Phosphate Tablets

Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines, including medicines obtained without a prescription or might take any other medicines. Especially:

• medicines to treat depression such as Monoamine Oxidase Inhibitors (MAOIs e.g. moclobemide, linezolid, selegiline. Avoid Codeine Phosphate Tablets for 2 weeks after stopping the MAOI) or tricyclics (e.g. amitriptyline)
• ciprofloxacin (antibacterial medicine)
• metoclopramide or domperidone (to prevent sickness)
• mexiletine or quinidine (to treat irregular heartbeats)
• loperamide or kaolin (to treat diarrhoea)
• cimetidine (to treat stomach ulcers)
• medicines used to treat high blood pressure
• antiviral medicines such as ritonavir
• medicines to treat allergies (antihistamines) that can cause drowsiness
• anticholinergic medicines like atropine
• medicines which affect the nervous system such as chlorpromazine, diazepam, temazepam
• anaesthetics
• opioid antagonists (buprenorphine, naltrexone, naloxone)
• gabapentin or pregabalin to treat epilepsy or pain due to nerve problems (neuropathic pain).

Concomitant use of Codeine Phosphate Tablets and sedative medicines such as benzodiazepines or related drugs increases the risk of drowsiness, difficulties in breathing (respiratory depression), coma and may be life-threatening. Because of this, concomitant use should only be considered when other treatment options are not possible.

However, if your doctor does prescribe Codeine Phosphate Tablets together with sedative medicines the dose and duration of concomitant treatment should be limited by your doctor.