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Codeine carries a significant risk of misuse and dependence, potentially resulting in overdose and death. Additionally, codeine may cause severe and possibly life-threatening respiratory issues. To minimize these risks, your healthcare provider should prescribe the lowest effective dose for the shortest duration necessary.

• Consider discussing with your doctor or pharmacist the availability of naloxone for opioid overdose emergencies. Educate your family or household on recognizing and responding to opioid overdoses.

• The likelihood of experiencing severe respiratory problems increases at the start of treatment, after a dose change, or if an incorrect dose is taken. Combining codeine with alcohol or other sedatives can lead to serious, potentially fatal side effects. Additionally, other medications can interfere with codeine clearance from the body, affecting its efficacy. Ensure you understand the proper use of this medication and which substances to avoid.

• Seek immediate medical attention if you experience symptoms such as slow or shallow breathing, pronounced dizziness, severe drowsiness, or difficulty rousing.

• Store this medication securely to prevent theft, misuse, or abuse. If someone ingests this medication accidentally, seek urgent medical assistance.

• This product contains acetaminophen, excessive consumption of which can cause serious liver damage, potentially leading to death. Adults should not exceed 4000 milligrams (4 grams) per day, with lower limits for those with liver issues and children. Confirm safe acetaminophen dosages with your healthcare provider.

• Avoid using other acetaminophen-containing medications without consulting a doctor or pharmacist, as it is prevalent in many over-the-counter and prescription drugs. Check all medication labels, and consult your pharmacist if uncertain.

• In case of acetaminophen overdose, seek immediate medical help even if symptoms are not apparent. Overdose signs include nausea, vomiting, appetite loss, sweating, abdominal pain, extreme fatigue, jaundice, and dark urine.

• Daily alcohol consumption, especially with acetaminophen, can harm the liver; therefore, alcohol should be avoided.

• Women of childbearing age should discuss potential risks and benefits with their healthcare provider before using this medication. Inform your doctor if you are pregnant or planning to conceive. During pregnancy, codeine should only be used when absolutely necessary, as it might slightly elevate the risk of birth defects in early pregnancy. Prolonged or high-dose use near delivery can harm the unborn child. To reduce risk, use the smallest effective dose for the shortest possible duration. Newborns exposed to this medication for extended periods may exhibit severe withdrawal symptoms. Contact a doctor immediately if symptoms such as persistent crying, slow or shallow breathing, irritability, tremors, vomiting, diarrhea, feeding difficulties, or poor weight gain occur.

• Codeine is not recommended for children under 18, as they may be particularly sensitive to its effects, leading to serious respiratory issues. This risk is higher in obese children, those with breathing problems, or following specific surgeries like tonsil or adenoid removal. Discuss the risks and benefits with your healthcare provider.

You may experience nausea, vomiting, abdominal pain, tremors, shortness of breath, constipation, dry mouth, lightheadedness, dizziness, drowsiness, or trouble sleeping when taking this medication. These side effects are usually mild, but if they persist or worsen, consult your healthcare provider. To minimize dizziness and lightheadedness, rise slowly from sitting or lying positions. To prevent constipation, incorporate dietary fiber, stay hydrated, and exercise regularly. A laxative may also be helpful—consult your pharmacist for recommendations.

While most people using this medication do not encounter serious side effects, it is important to be aware of potential risks. Serious side effects can include sleep apnea, mood changes, irregular heartbeat, increased thirst or urination, persistent sore throat or fever, easy bruising or bleeding, difficulty urinating, and symptoms indicating adrenal gland issues like loss of appetite, unusual fatigue, or weight loss. If you experience any of these, contact your healthcare provider immediately.

In rare cases, the medication may cause fainting or seizures, requiring urgent medical attention. Additionally, some individuals metabolize codeine into morphine more rapidly, posing a risk of severe side effects such as slow or shallow breathing, extreme drowsiness, difficulty waking, and confusion. If you experience these symptoms, seek emergency medical help.

Allergic reactions to this medication are very rare but can be serious. Symptoms might include rash, itching or swelling (especially of the face, tongue, or throat), severe dizziness, or trouble breathing. If you notice these, get immediate medical assistance. This summary does not cover all possible side effects. If you observe other unexpected effects, reach out to your healthcare provider for guidance.

This medication may interact with various products, such as darunavir, isoniazid, lithium, methoxyflurane, naltrexone, certain pain medications (like morphine, nalbuphine, pentazocine), phenothiazines (such as chlorpromazine), samidorphan, and sodium oxybate. It can accelerate the elimination of other drugs from your body, possibly affecting their efficacy. Drugs that may be affected include doxycycline, estrogen, felodipine, lonafarnib, quinidine, rilpivirine, tamoxifen, theophylline, blood thinners (e.g., warfarin), specific beta blockers (like metoprolol), and corticosteroids (such as prednisone).

Taking this medication with other products that cause drowsiness or breathing issues could increase the risk of severe side effects like slow or shallow breathing and extreme drowsiness or dizziness. Inform your doctor or pharmacist if you use other opioid pain or cough products (such as morphine, hydrocodone), alcohol, marijuana, sleep or anxiety medications (like alprazolam, lorazepam, zolpidem), muscle relaxants (such as carisoprodol, cyclobenzaprine), or antihistamines (such as cetirizine, diphenhydramine).

Check the labels of all your medications, including those for allergies or colds, since they might contain caffeine or ingredients that cause drowsiness. Beverages like coffee, colas, and tea may also have caffeine. Consult your pharmacist for guidance on using these products safely.

Other drugs can influence the removal of this medication from your system, which might impact its effectiveness. These include azole antifungals (like ketoconazole), bupropion, fluoxetine, macrolide antibiotics (such as erythromycin), levoketoconazole, paroxetine, quinidine, rifamycins (like rifabutin, rifampin), ritonavir, and certain seizure medications (such as carbamazepine, phenytoin).

Additionally, this medication may reduce the effectiveness of hormonal birth control methods such as pills, patches, or rings, possibly leading to pregnancy. Discuss with your doctor or pharmacist whether you need a reliable backup birth control method while taking this medication. Notify your doctor if you experience any new spotting or breakthrough bleeding, as these could indicate that your birth control is not working effectively.

This medication might interfere with specific medical or lab tests (like urine 5-HIAA levels, urine VMA levels, urine catecholamine levels, amylase and lipase levels, dipyridamole-thallium imaging tests), potentially causing inaccurate results. Ensure that lab personnel and all your healthcare providers are aware of your medication use.