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.

On this page: What's changed and why? | Resources for the community | Resources for health professionals | Resources for wholesalers, sponsors and retail pharmacies | Contact details | Related information

What's changed and why?

What's changed?

Codeine became a Prescription Only Medicine on 1 February 2018.

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

• Codeine use can be harmful
• Frequently asked questions about codeine
• Fact sheets
  • Community fact sheet: Codeine-containing medicines: Harms and changes to patient access
  • Community fact sheet: Codeine access for rural and remote Australians
• How and where to get advice
  • Chronic pain management
  • National support services
  • State and territory support services
• National Codeine Communication Strategy
• Codeine news
  • The TGA statement in relation to ABC's Fact Check article on deaths from OTC codeine

Resources for health professionals

All health professionals

• Codeine use can be harmful
• Codeine harm and efficacy literature
• Education resources for health professionals
• National Codeine Communication Strategy
• Presentations: Codeine up-scheduling workshops, Melbourne, 28 November 2017
• Presentations: Codeine up-scheduling workshops, Perth, 30 November 2017
• Presentations: Codeine up-scheduling workshops, Brisbane, 13 December 2017
• Presentations: Codeine up-scheduling workshops, Wagga Wagga, 14 December 2017
• Codeine news
  • The TGA statement in relation to ABC's Fact Check article on deaths from OTC codeine

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

• Tips for talking about codeine: Guidance for health professionals with prescribing authority
• Education resources for general practitioners

Emergency department health professionals

• Education resources for emergency department health professionals

Nurses and midwives

• Nurses and midwives fact sheet: Talking to people about changes to codeine access
• Education resources for nurses and midwives

Pharmacists

• Pharmacist fact sheet: Talking to your patients about the changes to codeine access
• Tips for talking about codeine: Guidance for pharmacists
• Case studies: Pain management and codeine use
• Education resources for pharmacists

Pharmacy assistants

• Tips for talking about codeine: Guidance for pharmacy assistants
• What can pharmacy assistants say to customers about specific pain relief products?

Allied health professionals

• Education resources for allied health professionals
• Fact sheets:
  • Physiotherapist fact sheet: Talking to people about the changes to codeine access

Resources for wholesalers, sponsors and retail pharmacies

• Codeine stock management for wholesalers, sponsors and retail pharmacies
• Codeine Industry Forum
• Frequently asked questions - industry sponsors of codeine-containing products
• Preparing education materials and advertising for pain relief products