Codeine

The chemical structure of Codeine

Codeine (also called methylmorphine) is an opiate used for its analgesic effects on people. It is made to treat cough and diarrhea. It is marketed as the salts codeine sulfate and codeine phosphate. Codeine hydrochloride is more commonly marketed in continental Europe and other regions.

Codeine is an alkaloid found in opium in concentrations ranging from 0.3 to 3.0 percent. Opium contains codeine which can be extracted. Today, most codeine is synthesized from morphine through the process of O-methylation.

Uses

Codeine is used to treat the following:

• Cough, though its efficacy in low dose over the counter formulations has been disputed.
• Diarrhea
• Moderate to severe pain
• Irritable bowel syndrome

Compound analgesics

Codeine is often marketed as drugs in combination with paracetamol (acetaminophen) as co-codamol (best known in North America as Tylenol 3). Research has shown the combination to be very much more effective than paracetamol. It is suggested that that pure codeine is much more addictive with a higher risk abuse.

There are similar combinations with aspirin as co-codaprin or with ibuprofen. These combinations provide greater pain relief than either agent alone.

Drug synergy is an important principle.