Codeine is a weak opioid painkiller. In many areas of the world, it is the only approved opioid that is sold over-the-counter, typically mized with other non-opioid drugs, such as acetaminophen.
|US||Rx Only (Schedule II, III)|
Schedule V, currently unavailable (see Legality)
|Canada||OTC when mixed with 2 or more other drugs|
|EU|| OTC when mixed with other drugs|
|Onset of Action||30-60 minutes|
|Duration of Action||4-6 hours|
|Therapeutic Index||Moderate (1:20)|
|Brand names|| Prometh with Codeine (discontinued)|
Robitussin AC (discontinued)
Legality and Availability
Codeine is freely available in small amounts in many countries. Unfortunately, the United States is not one of them. Codeine cough syrup used to be available, but has since been pulled from the market.
Codeine in combination products is available without a prescription in Canada, Mexico, Australia, and most of Europe, including the United Kingdom and France.
Germany, the Netherlands, and other countries generally do not have codeine available over the counter. However, as EU member countries, citizens can order codeine combination products from other European countries.
In the West, codeine is rarely available in pure form over-the-counter. One notable exception is Padéryl in France.
It should be noted that the possession of codeine in the United States is not illegal. In fact, nonprescription codeine is technically legal and approved, although no pharmaceutical company currently makes an OTC solution due to liability concerns.
In March 2016, Indian authorities announced that cough syrup including codeine was to be banned. The government cited, among other reasons, the fact that diversion of codeine products is so widespread.
Codeine is an opioid with about 1/8 the potency of morphine when taken orally.
Codeine is an excellent painkiller for mild to moderate pain, and is effective in suppressing coughs.
Codeine has been noted to have anti-anxiety effects.
Many people use codeine recreationally, although due to its slow onset of action and long duration, it is considered less addictive than other stronger and faster-acting opioids such as oxycodone and heroin.