Codeine information hub

Changes to patient access for medicines containing codeine

10 April 2018

No therapeutic product is ever completely risk free. Some risks may be known when a medicine or medical device is first entered on the Australian Register of Therapeutic Goods (ARTG). However, some information only comes to light after more people use the products.

What's changed and why?

What's changed?

Codeine became a Prescription Only Medicine on 1 February this year.

Many codeine-containing products previously available over-the-counter are still available with a prescription. See the Current list of up-scheduled codeine containing products.

Products containing codeine derivatives, pholcodine, dextromethorphan, and dihydrocodeine are unaffected by the decision to up-schedule codeine.

Why did access to low-dose codeine-containing medicines change?

The Australian Government is committed to delivering the best health outcomes for Australians through the appropriate regulation of medicines that are deemed by medical experts to have particular risks. This includes low dose codeine-containing medicines.

The evidence shows that medicines containing low-dose codeine combined with paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or aspirin, are generally no more effective than other non-codeine medicines.

The use of low-dose codeine-containing medicines is associated with high health risks. Codeine is an opioid drug closely related to morphine and, like morphine, is also derived from opium poppies. Codeine, like morphine and other opioids, can cause opioid tolerance, dependence, toxicity and in higher doses, death.

Regular use of medicines containing codeine, for example for chronic pain, has led to some consumers becoming addicted to codeine without realising it. The risks associated with codeine use are too high without oversight from a doctor. See 'Codeine use can be harmful' and 'How and where to get advice'.

Further information on the reasons for the change to codeine access can be found on the TGA website: Scheduling delegate's final decision: codeine, December 2016

Explore the links below to find out more.

Resources for the community

Resources for health professionals

All health professionals

General practitioners, specialists, nurse practitioners and other health professionals with prescribing authority

Emergency department health professionals

Nurses and midwives

Pharmacists

Pharmacy assistants

Allied health professionals

Resources for wholesalers, sponsors and retail pharmacies