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Codeine information hub: Codeine use can be harmful

Related information

4 April 2018

Most Australians are unaware that low dose codeine (

Signs of codeine dependence: Loss of appetite and weight loss; nausea and vomiting; cold sweats, clammy hands and feet; poor physical coordination; using more codeine to get the same effect; unable to stop of cut down on the use of codeine; confusion; mood swings; changes in sleeping patterns; it is affecting your life - you may be losing interest in regular activities, are often late or absent from work or school or having relationship problems

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.

Possible side effects of using codeine: headache, addiction and tolerance, nausea, drowsiness, dizziness, difficulty breathing, constipation

Codeine poisoning contributes to both accidental and intentional deaths in Australia. Low-dose codeine-containing medicines 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:

Additional information on codeine harm can be found on:

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International regulation of codeine

Australia is not unique in its requirements to have a prescription for codeine containing products. Countries in Europe including Austria, Belgium, France, Germany and Italy, well as the United States, Japan, Russia, and the United Arab Emirates all require prescriptions for medicines containing codeine. In some other countries including Hong Kong, Hungary and the Netherlands, OTC sale of cough linctus (containing codeine) is allowed, with all other medicines containing codeine requiring a prescription. Most recently the new French Government announced in July 2017 that all medicines containing codeine would only be available via prescription.

A prescription is required in: USA, Most of Europe, India, Japan

Most recently, in January 2018, the Kenya Pharmacy and Poisons Board announced that all medicines containing codeine have been rescheduled to Prescription Only Medicines. Canada and New Zealand are also currently considering whether to make codeine medicines Prescription Only.