Codeine is a prescription painkiller.
Codeine overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.
This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.
- Actifed with codeine
- Empirin #3
- Oxa forte
- Promethazine with codeine cough syrup
- Robitussin A-C
- Tylenol #3
- Voltaren forte
Note: This list may not be all-inclusive.
- Bluish-colored fingernails and lips
- Breathing problems -- slow and labored breathing, shallow breathing, no breathing
- Cold, clammy skin
- Coma (decreased level of consciousness and lack of responsiveness)
- Loss of consciousness
- Low blood pressure
- Muscle twitches
- Pinpoint pupils
- Spasms of the stomach and intestines
- Weak pulse
Before Calling Emergency
Determine the following information:
- Patient's age, weight, and condition
- The name of the product (ingredients and strengths, if known)
- When it was swallowed
- The amount swallowed
- If the medication was prescribed for the patient
The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.
This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.
What to Expect at the Emergency Room
The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate. The patient may receive:
- Activated charcoal
- Breathing support, including a tube through the mouth and breathing machine (ventilator)
- Chest x-ray
- EKG (heart tracing)
- Fluids through a vein (by IV)
- Medication to reverse the effect of the painkiller (a narcotic antagonist)
- Tube through the nose into the stomach to empty the stomach (gastric lavage)
Codeine is usually found in combination with other medications such as acetaminophen. Therefore, the outcome also depends on how well the toxicity of these other medications is treated. Shock, brain damage, and death are possible.
Murphy NG, Benowitz NL, Goldschlager N. Cardiovascular toxicology. In: Shannon MW, Borron SW, Burns MJ, eds.Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose
Yip L, Megarbane B, Borron SW. Opioids. In: Shannon MW, Borron SW, Burns MJ, eds.Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose
Bardsley CH. Opioids. In: Marx JA, Hockberger RS, Walls RM, et al., eds.Rosen's Emergency Medicine: Concepts and Clinical Practice
Update Date 1/22/2014
Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.