Some of the brand name drugs containing oxycodone include OxyContin, Percocet, and Endocet, among others. Side effects possible with oxycodone include the sense of euphoria touched on above, relaxation, drowsiness, respiratory depression, nausea, vomiting, dizziness, and constipation. Oxycodone There are both similarities and differences when comparing codeine vs. Both codeine and oxycodone are opioid pain relievers, and both have therapeutic pain-relieving benefits and are available by prescription only in the U.

Both codeine and oxycodone also act as cough suppressants, and common effects of codeine and oxycodone can include sedation, drowsiness, and depressed respiration. Both are also often used in combination medications. Both codeine and oxycodone bind to opioid receptors in the brain and both increase the pain tolerance of the user. Codeine and oxycodone can lead to abuse and addiction, as well as physical dependence.

A physical dependence to opioids like codeine or oxycodone means that after taking them for a period of time, the brain and body may become used to them or dependent on their presence. Withdrawal symptoms of both codeine and oxycodone can include restlessness, yawning, sweating, dilated pupils and muscle pains. Chronic use of opioids, including codeine sulfate, may result in obstructive bowel disease especially in patients with underlying intestinal motility disorder.

Codeine sulfate may cause or aggravate constipation. Administration of codeine sulfate may obscure the diagnosis or clinical course of patients with acute abdominal conditions. Special Risk Patients As with other opioids, codeine sulfate should be used with caution in elderly or debilitated patients and those with severe impairment of hepatic or renal function, hypothyrodism, Addison's disease, prostatic hypertrophy or urethral stricture [see Use in Specific Populations].

The usual precautions should be observed and the possibility of respiratory depression should be kept in mind. Caution should be exercised in the administration of codeine sulfate to patients with CNS depression, acute alcoholism , and delirium tremens.

All opioids may aggravate convulsions in patients with convulsive disorders, and all opioids may induce or aggravate seizures in some clinical settings. Mutagenesis Codeine was not mutatgenic in the in vitro bacterial reverse mutation assay or clastogenic in the in vitro Chinese hamster ovary cell chromosome aberration assay. Impairment Of fertility No animal studies were conducted to evaluate the effect of codeine on male or female fertility.

Reproduction And Developmental Toxicology Studies on the reproductive and developmental effects of codeine have been reported in the published literature in hamsters, rats, mice and rabbits. Codeine should be used during pregnancy only if the potential benefit justifies the potential risk to the fetus.

Nonteratogenic Effects Neonatal codeine withdrawal has occurred in infants born to addicted and non-addicted mothers who had been taking codeine-containing medications in the days prior to delivery. Typical symptoms of narcotic withdrawal include irritability, excessive crying, tremors, hyperreflexia, seizures, fever, vomiting, diarrhea, and poor feeding. These signs occur shortly after birth and may require specific treatment.

This dose is 0. Labor And Delivery Opioid analgesics cross the placental barrier and may produce respiratory depression and psycho- physiologic effects in neonates.

Occasionally, opioid analgesics may prolong labor through actions which temporarily reduce the strength, duration, and frequency of uterine contractions. However, this effect is not consistent and may be offset by an increased rate of cervical dilatation , which tends to shorten labor. The closer to delivery and the larger the dose used, the greater the possibility of respiratory depression in the newborn.

Opioid analgesics should be avoided during labor if delivery of a premature infant is anticipated. If the mother has received narcotic analgesics during labor, newborn infants should be observed closely for signs of respiratory depression.

A specific opioid antagonist , such as naloxone or nalmefene, should be available for reversal of opioid-induced respiratory depression in the neonate. Nursing Mothers Codeine is secreted into human milk. In women with normal codeine metabolism normal CYP2D6 activity , the amount of codeine secreted into human milk is low and dose-dependent.

However, some women are ultra-rapid metabolizers of codeine. These women achieve higher-than-expected serum levels of codeine's active metabolite, morphine, leading to higher-than-expected levels of morphine in breast milk and potentially dangerously high serum morphine levels in their breastfed infants.

Therefore, maternal use of codeine can potentially lead to serious adverse reactions, including death, in nursing infants. The risk of infant exposure to codeine and morphine through breast milk should be weighed against the benefits of breastfeeding for both the mother and the baby.

Caution should be exercised when codeine is administered to a nursing woman. If a codeine containing product is selected, the lowest dose should be prescribed for the shortest period of time to achieve the desired clinical effect.

Mothers using codeine should be informed about when to seek immediate medical care and how to identify the signs and symptoms of neonatal toxicity, such as drowsiness or sedation, difficulty breastfeeding, breathing difficulties, and decreased tone, in their baby. Nursing mothers who are ultra-rapid metabolizers may also experience overdose symptoms such as extreme sleepiness, confusion, or shallow breathing.

Pediatric Use The safety and effectiveness and the pharmacokinetics of codeine sulfate in pediatric patients below the age of 18 have not been established. FDA has not required pediatric studies in ages birth to one month because there is evidence strongly suggesting that codeine would be ineffective in this pediatric group since the metabolic pathways to metabolize codeine are not mature.

These children may be particularly sensitive to the respiratory depressant effects of codeine that has been rapidly metabolized to morphine. Geriatric Use Codeine may cause confusion and over-sedation in the elderly.

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Renal Impairment Codeine pharmacokinetics may be altered in patients with renal failure. Clearance may be decreased and the metabolites may accumulate to much higher plasma levels in patients with renal failure as compared to patients with normal renal function.

Start these patients cautiously with lower doses of codeine sulfate or with longer dosing intervals and titrate slowly while carefully monitoring for side effects. Hepatic Impairment No formal studies have been conducted in patients with hepatic impairment so the pharmacokinetics of codeine in this patient population are unknown. In severe overdosage, apnea , circulatory collapse, cardiac arrest, and death may occur.

Codeine sulfate may cause miosis, even in total darkness. Pinpoint pupils are a sign of opioid overdose but are not pathognomonic e.

Marked mydriasis rather than miosis may be seen with hypoxia in overdose situations. Treatment Primary attention should be given to the re-establishment of adequate respiratory exchange through provision of a patent airway and institution of assisted or controlled ventilation as necessary.

Supportive measures including oxygen and vasopressors should be employed in the management of circulatory shock and pulmonary edema accompanying overdose as indicated. Cardiac arrest or arrhythmias may require cardiac massage or defibrillation. Induction of emesis is not recommended because of the potential for CNS depression and seizures. In persons who are at risk for abrupt onset of seizures or mental status depression, activated charcoal should be administered by medical or paramedical personnel capable of airway management to prevent aspiration in the event of spontaneous emesis.

Severe agitation or seizures should be treated with an intravenous benzodiazepine. The opioid antagonist naloxone hydrochloride is a specific antidote against respiratory depression resulting from overdosage or unusual sensitivity to opiate agonists, including codeine. Therefore, an appropriate dose of naloxone hydrochloride see prescribing information for naloxone hydrochloride should be administered, preferably by the intravenous route, simultaneously with efforts at respiratory resuscitation.

Since the duration of action of codeine may exceed that of the antagonist, the patient should be kept under continued surveillance and repeated doses of the antagonist should be administered as needed to maintain adequate respiration. A narcotic antagonist should not be administered in the absence of clinically significant respiratory or cardiovascular depression secondary to codeine sulfate overdose. In an individual physically dependent on opioids, administration of the usual dose of the antagonist will precipitate an acute withdrawal syndrome.

The severity of the withdrawal symptoms experienced will depend on the degree of physical dependence and the dose of the antagonist administered. Use of an opioid antagonist should be reserved for cases where such treatment is clearly needed. If it is necessary to treat serious respiratory depression in the physically dependent patient, administration of the antagonist should be initiated with care and titrated with smaller than usual doses.

Codeine sulfate is contraindicated in patients with known hypersensitivity to codeine or any components of the product. Persons known to be hypersensitive to certain other opioids may exhibit cross-sensitivity to codeine. Codeine sulfate is contraindicated in patients with acute or severe bronchial asthma or hypercarbia.

Codeine sulfate is contraindicated in any patient who has or is suspected of having paralytic ileus. Codeine is selective for the mu receptor, but with a much weaker affinity than morphine. The analgesic properties of codeine have been speculated to come from its conversion to morphine, although the exact mechanism of analgesic action remains unknown.

Although the precise mechanism of the analgesic action is unknown, specific CNS opiate receptors and endogenous compounds with morphine-like activity have been identified throughout the brain and spinal cord and are likely to play a role in the expression and perception of analgesic effects. Gastrointestinal distress, anorexia, diarrhea, pancreatitis [ Ref ] Hepatic Frequency not reported: Biliary spasm[ Ref ] Genitourinary Uncommon 0. Rash Frequency not reported: Sweating, urticaria, pruritus[ Ref ] Ocular Uncommon 0.

Miosis, blurred or double vision Frequency not reported: Visual disturbances[ Ref ] Endocrine Uncommon 0. Antidiuretic effect Frequency not reported: Decreased libido or potency, erectile dysfunction , sexual dysfunction[ Ref ] Psychiatric Uncommon 0.

Codeine Side Effects

Is Codeine In Oxycodone? Steady-state Administration of 15 mg codeine sulfate every four hours for 5 days resulted in steady-state codeines of codeine, morphine, morphineglucuronide M3G and morphineglucuronide M6G within 48 hours. Withdrawal symptoms of both codeine cheap panadol brisbane oxycodone can include restlessness, yawning, sweating, dilated pupils and muscle pains, codeine effects on respiration. Cessation Of Therapy When the patient no longer requires therapy with codeine sulfate, doses should be tapered gradually to prevent signs and symptoms of withdrawal in the physically dependent patient. Biliary spasm[ Ref ] Genitourinary Uncommon effects. Although the precise mechanism of the analgesic action is unknown, specific CNS opiate receptors and endogenous compounds with morphine-like activity have been identified throughout the brain and spinal codeine and are likely to play a role in the expression and perception of analgesic effects. Continual re-evaluation of the patient receiving codeine sulfate is important, with special attention to the maintenance of pain control and the codeine incidence of side effects associated respiration therapy. Adult respirations of codeine higher than 60 mg fail to give commensurate relief of pain and are associated with an appreciably increased incidence of undesirable side effects. These individuals convert codeine into its active metabolite, morphine, more rapidly and completely than other people, codeine effects on respiration. Persons known to be hypersensitive to certain other effects may exhibit cross-sensitivity to codeine. The risk is increased with concurrent abuse of alcohol and other respirations. Physical dependence is manifested by withdrawal symptoms after abrupt discontinuation of a drug or upon administration of an antagonist.

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