Long COVID Patterns in the RECOVER-Adult Study
November 21, 2025
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Brand Name :
Contin
Synonyms :
codeine
Class :
Brand Name :
Contin
Synonyms :
codeine
Class :
Dosage forms and strengths Â
Tablet- (Schedule II)Â
60mgÂ
30mgÂ
15mgÂ
Take 15-60 mg orally every 4-6 hours as needed
not exceed a daily dose of 360 mg in new patients
indicated for Cough (Off-label) The dosage is 7.5-30 mg orally every 4-6 hours as needed
Dosage forms and strengthsÂ
Tablet- (Schedule II)Â
60mgÂ
30mgÂ
15mgÂ
oral solution- (Schedule II)Â
30mg/mLÂ Â
The Food and Drug Administration (FDA) issued the utilization of codeine should be avoided in children under the age of 12, as well as in all pediatric patients undergoing tonsillectomy and/or adenoidectomyÂ
off-label:
Age(≥12 years)- The dosage of 0.5-1 mg/kg every 4-6 hours as needed
Ensure not to exceed a maximum dose of 60 mg/ dose. Adjust the dosage based on the level of pain relief required
It is advisable to take the minimum effective dosage for the shortest feasible period
Alternatively, the dosage is 15-60 mg orally every 4-6 hours as needed, with a maximum daily limit of 360 mg for patients who are new to the medication
off-label:
Age(≥ 12 years)- The dosage is 7.5-30 mg taken orally every 4-6 hours as needed
Adjust the dose gradually based on the level of pain relief experienced
It is important to administer the lowest effective dose for the shortest duration possible
Refer adult dosingÂ
The interaction may increase the risk of sedation, respiratory depression, and coma
The interaction may increase the risk of sedation, respiratory depression, and coma
The interaction may increase the risk of sedation, respiratory depression, and coma
The interaction may increase the risk of sedation, respiratory depression, and coma
The interaction may increase the risk of sedation, respiratory depression, and coma
Concurrent use within 14 days after pholcodine treatment may lead to serotonin syndrome
may increase the CNS depressant effect of primidone
may have an increased CNS depressant effect when combined with opioid agonists
may have an increased CNS depressant effect when combined with opioid agonists
may have an increased CNS depressant effect when combined with opioid agonists
may have an increased CNS depressant effect when combined with opioid agonists
may have an increased CNS depressant effect when combined with opioid agonists
may increase the depressant effect of opioid agonists
may increase the depressant effect of opioid agonists
may increase the depressant effect of opioid agonists
may enhance the serum concentration
may increase the CNS depressant effect
may increase the CNS depressant effect of CNS depressants
acrivastine and pseudoephedrineÂ
may increase the CNS depressant effect of CNS depressants
may increase the CNS depressant effect of CNS depressants
may have an increased CNS depressive effect when combined with opioid agonists
may have an increased CNS depressive effect when combined with opioid agonists
may have an increased CNS depressive effect when combined with opioid agonists
may have an increased CNS depressive effect when combined with opioid agonists
may have an increased CNS depressive effect when combined with opioid agonists
may have an increasingly adverse effect when combined with alvimopan
may increase the CNS depressant effect of CNS depressants
may increase the CNS depressant effect of CNS depressants
may increase the CNS depressant effect of CNS depressants
may increase the CNS depressant effect of CNS depressants
may increase the CNS depressant effect of CNS depressants
may increase the CNS depressant effect of CNS depressants
may increase the CNS depressant effect of CNS depressants
promethazine/dextromethorphanÂ
may increase the CNS depressant effect of CNS Depressants
promethazine/dextromethorphanÂ
may increase the CNS depressant effect of CNS Depressants
may increase the CNS depressant effect of PHENobarbital
may increase the CNS depressant effect of CNS Depressants
may increase the CNS depressant effect of CNS Depressants
may increase the CNS depressant effect of CNS Depressants
acetaminophen/doxylamine/dextromethorphanÂ
may increase the CNS depressant effect CNS Depressants
may increase the toxic effect of each other when combined
nalmefene: they may decrease the therapeutic effect of opioid drug
CNS stimulants: they may increase the CNS stimulant effect of opioid drugs
CNS stimulants: they may increase the CNS stimulant effect of opioid drugs
CNS stimulants: they may increase the CNS stimulant effect of opioid drugs
CNS stimulants: they may increase the CNS stimulant effect of opioid drugs
CNS stimulants: they may increase the CNS stimulant effect of opioid drugs
may have an increased Effect of CNS depressant when combined with serotonergic opioids
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
may enhance the serum concentration of each other when it is combined
The interaction may enhance the risk of anaphylaxis
The interaction may enhance the risk of anaphylaxis
The interaction may enhance the risk of anaphylaxis
The interaction may enhance the risk of anaphylaxis
The interaction may enhance the risk of anaphylaxis
they decrease the effect of analgesia of opioid agonists
they decrease the effect of analgesia of opioid agonists
they increase the efficacy of other opioid agonists
they increase the efficacy of other opioid agonists
they increase the efficacy of other opioid agonists
they increase the efficacy of other opioid agonists
may have an increasingly adverse effect when combined with codeine
may have an increasingly adverse effect when combined with codeine
may have an increasingly adverse effect when combined with codeine
may have an increasingly adverse effect when combined with codeine
may have an increasingly adverse effect when combined with codeine
It may enhance sedation when combined with codeine
may diminish the analgesic effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
may decrease the analgesic effect when combined with opioid agonists
may decrease the analgesic effect when combined with opioid agonists
CYP3A enhancers (strong) may decrease plasma concentrations of the active metabolite(s) of codeine
it increases the effect of CNS depressants
it increases the effect of CNS depressants
CNS depressants increase the efficacy of flunarizine
may increase the CNS depressant effect
may decrease the therapeutic effect of opioids
may increase the constipation effect of opioid agonist
CNS depressants increase the CNS depressing effect of thalidomide
they increase the efficacy of other opioid agonists
they increase the efficacy of other opioid agonists
they increase the efficacy of other opioid agonists
they increase the efficacy of other opioid agonists
they increase the toxicity of opioid agonists
they increase the toxicity of opioid agonists
they increase the toxicity of opioid agonists
they increase the toxicity of opioid agonists
they increase the toxicity of opioid agonists
may decrease the analgesic effect of opioids
may have an increased constipating effect when combined with eluxadoline
may decrease the therapeutic effect when combined with opioid agonists
methylnaltrexone: they may increase the adverse effect of opioid antagonists
samidorphan: they may decrease the therapeutic effect of opioid agonists
may decrease the therapeutic effect of Nalmefene
The inhibition of gastrointestinal (GI) absorption by codeine leads to a decrease in the level or effectiveness of prasugrel
The GI absorption inhibition caused by codeine results in a decrease in the level or effectiveness of ticagrelor
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance the effect when combined with pharmacodynamic synergism
It may enhance the effect when combined with pharmacodynamic synergism
It may enhance the effect when combined with pharmacodynamic synergism
It may enhance sedation when combined with codeine
may diminish the analgesic effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
It may lead to sedation, respiratory depression, and coma
It may lead to sedation, respiratory depression, and coma
It may lead to sedation, respiratory depression, and coma
It may lead to sedation, respiratory depression, and coma
It may lead to sedation, respiratory depression, and coma
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
The interaction may enhance the hypotensive effects of opioid anti-tussive agents
may enhance the adverse/toxic effect of diuretics
may enhance the adverse/toxic effect of diuretics
may enhance the adverse/toxic effect of diuretics
may enhance the adverse/toxic effect of diuretics
may enhance the adverse/toxic effect of diuretics
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
may reduce the therapeutic effect of gastrointestinal agents
anticholinergic agents increase the toxicity of opioid agents
anticholinergic agents increase the toxicity of opioid agents
anticholinergic agents increase the toxicity of opioid agents
anticholinergic agents increase the toxicity of opioid agents
anticholinergic agents increase the toxicity of opioid agents
codeine: they may diminish serum concentrations of CYP3A4 Inducers
codeine: they may diminish serum concentrations of CYP3A4 Inducers
codeine: they may diminish serum concentrations of CYP3A4 Inducers
codeine: they may diminish serum concentrations of CYP3A4 Inducers
codeine: they may diminish serum concentrations of CYP3A4 Inducers
spironolactone and hydrochlorothiazide
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
spironolactone and hydrochlorothiazide
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
It may enhance sedation when combined with oxycodone
may have an increased analgesic effect when combined with opioid agonists
may have an increased analgesic effect when combined with opioid agonists
may have an increased analgesic effect when combined with opioid agonists
may have an increased analgesic effect when combined with opioid agonists
may have an increased analgesic effect when combined with opioid agonists
codeine: they may enhance the serum concentration of CYP2D6 Inhibitors
codeine: they may enhance the serum concentration of CYP2D6 Inhibitors
codeine: they may enhance the serum concentration of CYP2D6 Inhibitors
codeine: they may enhance the serum concentration of CYP2D6 Inhibitors
codeine: they may enhance the serum concentration of CYP2D6 Inhibitors
When encainide is used together with codeine, this leads to a reduction in the encainide’s metabolism
When emylcamate is used together with codeine, this leads to enhanced risk or seriousness of CNS depression
opioid drugs: they may enhance the serum concentration of CYP2D6 Inhibitors
opioid drugs: they may enhance the serum concentration of CYP2D6 Inhibitors
opioid drugs: they may enhance the serum concentration of CYP2D6 Inhibitors
opioid drugs: they may enhance the serum concentration of CYP2D6 Inhibitors
opioid drugs: they may enhance the serum concentration of CYP2D6 Inhibitors
opioid drugs: they may increase the sedative effect of CNS stimulants
opioid drugs: they may increase the sedative effect of CNS stimulants
opioid drugs: they may increase the sedative effect of CNS stimulants
opioid drugs: they may increase the sedative effect of CNS stimulants
opioid drugs: they may increase the sedative effect of CNS stimulants
When indisulam is used together with codeine, this leads to a reduction in codeine metabolism
When codeine is used together with profenamine, this leads to enhanced risk or seriousness of adverse events
it may reduce the therapeutic effect of gastrointestinal agents
it may reduce the therapeutic effect of gastrointestinal agents
it may reduce the therapeutic effect of gastrointestinal agents
it may reduce the therapeutic effect of gastrointestinal agents
it may reduce the therapeutic effect of gastrointestinal agents
anticholinergic agents may enhance the adverse/toxic effect of opioid agonists
anticholinergic agents may enhance the adverse/toxic effect of opioid agonists
anticholinergic agents may enhance the adverse/toxic effect of opioid agonists
anticholinergic agents may enhance the adverse/toxic effect of opioid agonists
anticholinergic agents may enhance the adverse/toxic effect of opioid agonists
CNS Depressants may enhance the CNS depressant effect of Opioid agonists
CNS Depressants may enhance the CNS depressant effect of Opioid agonists
CNS Depressants may enhance the CNS depressant effect of Opioid agonists
CNS Depressants may enhance the CNS depressant effect of Opioid agonists
CNS Depressants may enhance the CNS depressant effect of Opioid agonists
CNS depressants increase the effect of sedation of rotigotine
may increase the CNS depressant effect of opioid agonists
may increase the CNS depressant effect of opioid agonists
may increase the CNS depressant effect of opioid agonists
may increase the CNS depressant effect of opioid agonists
may increase the CNS depressant effect of opioid agonists
may enhance the risk of adverse/toxic effect of alvimopan
may enhance the adverse/toxic effect of naloxegol
may increase the analgesic effect of opioid agonists
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may increase the toxic effects of opioid agonists
may decrease the therapeutic activity of opioid agonists
it increases the effect of CNS depressants
it increases the effect of CNS depressants
may enhance the CNS depressant effect of Opioid Agonists
may enhance the CNS depressant effect of Opioid Agonists
may enhance the CNS depressant effect of Opioid Agonists
may enhance the CNS depressant effect of Opioid Agonists
may enhance the CNS depressant effect of Opioid Agonists
may enhance the risk of adverse effect of Opioid agonists
may enhance the risk of adverse effect of Opioid agonists
may enhance the risk of adverse effect of Opioid agonists
may enhance the risk of adverse effect of Opioid agonists
may enhance the risk of adverse effect of Opioid agonists
may reduce the analgesic effect of Opioid agonists
may reduce the analgesic effect of Opioid agonists
may reduce the analgesic effect of Opioid agonists
may reduce the analgesic effect of Opioid agonists
may reduce the analgesic effect of Opioid agonists
may decrease the therapeutic effect of anticholinergic agents
may enhance the CNS depressant effect
may enhance the CNS depressant effect
may enhance the CNS depressant effect
may increase the toxic effect of Anticholinergic Agents
may enhance the serum concentration of CYP3A4 Inhibitors
may enhance the adverse/toxic effect
may enhance the adverse/toxic effect
may enhance the adverse/toxic effect
may enhance the adverse/toxic effect
may enhance the adverse/toxic effect
pegvisomant: they may decrease the therapeutic effect of opioid agonists
ramosetron: they may increase the constipating effect of opioid drugs
may increase the CNS depressant effect
may increase the CNS depressant effect
may increase the CNS depressant effect
may increase the risk of adverse effects of opioid agonists
may increase the risk of adverse effects of opioid agonists
may increase the risk of adverse effects of opioid agonists
may increase the risk of adverse effects of opioid agonists
may increase the risk of adverse effects of opioid agonists
may increase the risk of adverse effects of opioid agonists
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may reduce the therapeutic effect
may increase the analgesic effect of opioid agonists
may increase the analgesic effect of opioid agonists
may increase the analgesic effect of opioid agonists
may increase the analgesic effect of opioid agonists
may increase the analgesic effect of opioid agonists
brivaracetam and codeine lead to increased sedative effects
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
It may enhance sedation when combined with codeine
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may enhance the levels of serum concentration
may enhance the levels of serum concentration
may enhance the levels of serum concentration
may enhance the levels of serum concentration
may enhance the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may reduce the levels of serum concentration
may increase the risk of adverse effect
may increase the risk of adverse effect
may increase the risk of adverse effect
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may enhance the effect of serotonergic activity
may have an increasingly adverse effect when combined with opioid agonists
may have an increasingly adverse effect when combined with opioid agonists
may have an increasingly adverse effect when combined with opioid agonists
may have an increasingly adverse effect when combined with opioid agonists
may have an increasingly adverse effect when combined with opioid agonists
amphetamines: they may increase the analgesic effect of opioid drugs
desmopressin: they may increase the toxic effect of opioid drugs
nitric oxide: they may increase the toxic effect of opioid drugs
somatostatin analogs: they may diminish serum concentrations of codeine
succinylcholine: they may increase the bradycardic effect of opioid drugs
sedative effects can be increased when codeine is administered with papaverine
sedative effects will be decreased with caffeine and increased with codeine
may have an increasingly adverse effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
may diminish the analgesic effect when combined with opioid agonists
may have a decrease in excretion when combined with codeine
spironolactone and hydrochlorothiazide
may increase the adverse/toxic effect of diuretics
may increase the adverse/toxic effect of diuretics
may increase the adverse/toxic effect of diuretics
may increase the adverse/toxic effect of diuretics
may increase the adverse/toxic effect of diuretics
the rate of metabolism may be altered
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of opioids
CYP3A4 inducers decrease the concentration of opioids
CNS depressants increase the effect of opioid agonists
CNS depressants increase the effect of opioid agonists
CNS depressants increase the effect of opioid agonists
CNS depressants increase the effect of opioid agonists serotonergic opioids
CNS depressants increase the effect of opioid agonists serotonergic opioids
CNS depressants increase the effect of opioid agonists serotonergic opioids
tricyclic antidepressants increase the CNS depression effect of serotonergic opioids
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
it increases the effect of CNS depressants
Actions and SpectrumÂ
Action:Â
Opioid Receptor AgonistÂ
Cough SuppressionÂ
Spectrum:Â
Pain ManagementÂ
Cough ReliefÂ
Frequency defined Â
>10%Â
DrowsinessÂ
ConstipationÂ
1-10%Â
Tachycardia or bradycardiaÂ
HypotensionÂ
DizzinessÂ
ConfusionÂ
HeadacheÂ
False feeling of well-beingÂ
MalaiseÂ
LightheadednessÂ
RestlessnessÂ
Paradoxical CNS stimulationÂ
<1%Â
Respiratory depressionÂ
Anaphylactoid reaction (rare)Â
Hypotension, with IV useÂ
Seizure, with excessive dosesÂ
Â
Black Box Warning:Â Â
Life-Threatening Respiratory DepressionÂ
Interactions with Drugs Affecting Cytochrome P450 IsoenzymesÂ
Neonatal Opioid Withdrawal SyndromeÂ
Contraindication/Caution:Â Â
Cautions:Â
Pregnancy warnings:    Â
Pregnancy category: AU TGA pregnancy category: A
US FDA pregnancy category: Not assignedÂ
Lactation: Excreted into human milk is knownÂ
Pregnancy Categories:        Â
Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester.Â
Category B: There were a lack of studies on pregnant women and no evidence of risk to the fetus in animal experiments.  Â
Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.   Â
Category D: adequate data with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.  Â
Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.   Â
Category N: There is no data available for the drug under this category
Pharmacology:Â Â
codeine is a medication that belongs to the class of drugs known as opioids and is used primarily for its analgesic (pain-relieving) and antitussive (cough-suppressing) propertiesÂ
Pharmacodynamics:Â Â
mu receptor agonistÂ
Narcotic agonist analgesicÂ
antitussive activity   Â
Pharmacokinetics:Â
AbsorptionÂ
The onset of action takes place in 30-60 minutes for oral and 10-30 minutes for intramuscular.Â
Duration of action is 4-6 hours.Â
The Peak plasma concentration is achieved in 0.5-1 hour.Â
DistributionÂ
The bound protein is 25%.Â
The distribution volume range is 3.5 L/kg for oral and 2.6 L/kg for intramuscular.Â
MetabolismÂ
The metabolism of codeine take place in the liver by the cytochrome P450 enzyme system, particularly CYP2D6. It undergoes O-demethylation to form morphine, which is the active metabolite responsible for codeine’s analgesic effects.Â
Excretion and EliminationÂ
Excreted in the urine and feces.Â
The half life is 3-4 hours.Â
Administration: Â
Oral administration in forms of tablet and oral solution.Â
Patient information leafletÂ
Generic Name: codeineÂ
Why do we use codeine? Â
codeine is classified as an opioid analgesic that is administered to alleviate pain ranging from mild to moderately severe, as well as to assist in suppressing cough symptoms.Â
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