Codeine information hub
Changes to patient access for medicines containing codeine
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.
- Consumer fact sheet: Codeine-containing medicines: Harms and changes to patient access
- Pharmacist fact sheet: Talking to your patients about the changes to codeine access
- Fact sheet: Codeine access for rural and remote Australians
- Codeine stock management for wholesalers, sponsors and retail pharmacies
- Frequently asked questions about Codeine
- Tips for talking about codeine: Guidance for health professionals with prescribing authority
- Tips for talking about codeine: Guidance for pharmacists
- Tips for talking about codeine: Guidance for pharmacy assistants
Explore this page to find out more about the TGA's recent decision regarding medicines which contain codeine.
What's changing and why?
Codeine use can be harmful
Most Australians are unaware that over-the-counter medicines containing codeine for pain relief offer very little additional benefit when compared with - medicines without codeine. The use of such medicines however, is associated with high health risks, such as developing tolerance or physical dependence on codeine.
Tolerance occurs when codeine becomes less effective and so the body needs higher and higher doses to feel the same relief from your symptoms. Severe withdrawal symptoms can result when the medicine is stopped; these include head and muscle aches, mood swings, insomnia, nausea and diarrhoea. Some of these withdrawal symptoms, such as head or muscle aches mimic the symptoms that low-dose codeine products are often used to treat, leading to people incorrectly continuing to take the medicine longer or in higher doses.
Codeine poisoning contributes to both accidental and intentional deaths in Australia. The codeine-containing medicines that are currently available over-the-counter are usually combined with either paracetamol or ibuprofen. Long term use of high doses of paracetamol can also result in liver damage and the most severe adverse effects of long term ibuprofen use include serious internal bleeding, kidney failure and heart attack.
Codeine is also sometimes used in medicines to relieve the symptoms of cough and cold, however there are safer and more effective medicines available that may provide relief from these conditions. Talk to your pharmacist or doctor for advice on what may be best for you.
Further information on the health risks of low-dose codeine medicines can be found on the TGA website:
- George report: Review of the efficacy and safety of over-the-counter codeine containing analgesics for pain and codeine based antitussives
- Safety review: Codeine use in children and ultra-rapid metabolisers
- Codeine RIS
Additional information can be found on:
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How and where to get advice
Pharmacists have an important role to play in minimising harm from codeine
The current range of codeine-containing over-the-counter medicines will continue to be available without a prescription in pharmacies until 31 January 2018. Pharmacists will continue to be an important source of information and advice for consumers both before and after this date.
Most people should be able to manage acute pain or cough and cold symptoms with safer alternative medicines. For acute pain, this may include products containing paracetamol or ibuprofen, or the two products in combination. Your pharmacist will be able to provide advice on the most appropriate medicines for you. Speaking with your pharmacist is particularly important if you have any other medical conditions, such as stomach, kidney, liver or heart problems.
Talk to your doctor
People with ongoing pain should talk to their doctor or healthcare provider to determine better alternative treatment options. These may include: alternative over-the-counter or prescription medicines; non-medicine therapies from an allied health professional such as a physiotherapist; self-management tools such as exercise or relaxation; or referral to a pain specialist or pain management clinic.
Ask your doctor about a Medicare-funded care plan which will allow you access to a rebate for treatment from an allied health professional. Medicare provides a rebate for the preparation of a Chronic Disease Management (CDM) Plan and a Team Care Arrangement (TCA).
For more information see www.health.gov.au/internet/main/publishing.nsf/content/mbsprimarycare-chronicdisease-pdf-infosheet.
Chronic Pain management
Further resources and information for individuals experiencing chronic pain are available on the NPS MedicineWise website:
- Information on living with and managing chronic pain
- Tips for talking to your health professional, including a communication tool
- Other Useful links and resources for managing pain
- Managing Chronic pain video Dr Malcolm Hogg, Head of Pain Management Services, Royal Melbourne Hospital
- FAQs about chronic pain
If you think that you are unable to manage without codeine and experience some of the side effects of withdrawal talk to your doctor about getting help.
Chronic pain management video resources
National support services
- NPS MedicineWise
- Alcohol and Drug Information Service (ADIS)
- Pain Australia
- Chronic Pain Australia
- painHEALTH
- Australian Pain Management Association
- Ask Your Pharmacist
- Pain Management Network
- Pain Link Helpline 1300 340 357
- Healthdirect Australia - 24 Hour Health Advice Line 1800 022 222
Contact information for state and territory drugs & poisons units
| State/Territory | Website | Contact details |
|---|---|---|
| Australian Capital Territory (ACT) | ACT Health Pharmaceutical Services |
Email: hps@act.gov.au Phone: 02 6205 1700 or 02 6205 0998 |
| New South Wales (NSW) | NSW Ministry of Health Pharmaceutical Services |
Email: pharmserv@doh.health.nsw.gov.au Phone: 02 9391 9944 |
| Northern Territory (NT) | NT Department of Health Environmental Health - Medicines & Poisons Control |
Phone: 08 8922 7341 |
| Queensland (QLD) | QLD Health Medicines: Medicines Regulation & QualityPoisons: Poisons Management |
Medicines: Email: mrq@health.qld.gov.au Phone: 07 3328 9890 Poisons: Email: environmentalhazards@health.qld.gov.au Phone: 07 3328 9310 |
| South Australia (SA) | SA Health Medicines and Technology Policy and Programs |
Phone: 08 8204 1942 or 08 8226 7100 |
| Tasmania (TAS) | TAS Department of Health & Human Services Pharmaceutical Services |
Phone: 03 6166 0400 |
| Western Australia (WA) | WA Health Pharmaceutical Services |
Phone: 08 9222 6883 |
| Victoria (VIC) | VIC Department of Health & Human Services Drugs and Poisons Regulation |
Phone: 1300 364 545 |