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Codeine phosphate is an opioid medicine used in the UK to treat certain types of pain. It may be prescribed when other painkillers, such as paracetamol or ibuprofen, have not provided sufficient relief. Codeine is also available in combination medicines, including co-codamol, but codeine phosphate tablets contain codeine as the active opioid ingredient.
Codeine phosphate is available in different strengths, including 30mg and 60mg. The appropriate strength depends on the individual’s medical circumstances, the type and severity of pain, previous treatment and other medicines being taken.
Because codeine is an opioid, it should be used carefully. It can cause side effects such as constipation, nausea, sleepiness and dizziness, while prolonged use can result in tolerance, dependence and, in some people, addiction.
This guide explains the differences between codeine phosphate 30mg and 60mg and the important safety information patients should understand.
Important: This article is for general educational information only. Always follow the instructions from your prescriber and speak with a GP or pharmacist if you have questions about your treatment.
What Is Codeine Phosphate?
Codeine phosphate is a prescription opioid painkiller.
It works on the central nervous system and changes the way the brain and body process pain signals. NHS guidance describes codeine as an opioid used to treat pain, including pain following an operation or injury. It may be considered when medicines such as paracetamol or ibuprofen have not worked sufficiently.
Codeine is available as tablets and other formulations. The correct strength and formulation depend on the individual’s circumstances.
What Is Codeine Phosphate 30mg Used For?
Codeine phosphate 30mg may be prescribed for pain when an opioid analgesic is considered appropriate.
The exact reason for prescribing can vary. For example, a healthcare professional may consider codeine for certain types of pain following an injury or operation.
Treatment should always be based on an individual’s circumstances rather than simply choosing a particular strength because it worked for somebody else.
If your pain is not adequately controlled, speak to your doctor or pharmacist rather than taking additional tablets.
What Is Codeine Phosphate 60mg Used For?
Codeine phosphate 60mg contains twice the amount of codeine phosphate found in a 30mg tablet.
However, this does not mean that 60mg is automatically appropriate for someone experiencing more severe pain.
The correct dose depends on factors including:
- The individual’s medical condition
- The severity and type of pain
- Previous opioid exposure
- Other medicines being taken
- Age and general health
- Kidney or liver problems
- How the person responds to codeine
Your prescribed strength should therefore be followed exactly.
Codeine Phosphate 30mg vs 60mg
One of the most common questions about codeine phosphate is how the two strengths differ.
| Feature | Codeine Phosphate 30mg | Codeine Phosphate 60mg |
|---|---|---|
| Active medicine | Codeine phosphate | Codeine phosphate |
| Strength | 30mg | 60mg |
| Medicine type | Opioid | Opioid |
| Main purpose | Pain relief when prescribed | Pain relief when prescribed |
| Appropriate dose | Depends on individual prescription | Depends on individual prescription |
| Should you change strength yourself? | No | No |
The main difference is simply the amount of codeine phosphate in each tablet.
A higher-strength tablet can also increase the potential for opioid-related adverse effects. Never switch from 30mg to 60mg without appropriate medical advice.
How Does Codeine Work?
Codeine acts on opioid receptors in the central nervous system.
It changes how the brain perceives pain, helping to reduce the sensation of pain.
The body’s response to codeine can vary considerably between individuals. Codeine is metabolised into morphine by an enzyme called CYP2D6, and genetic differences can affect how quickly this happens. This is one reason why the effects and risks can differ between people.
For this reason, the prescribed strength should not be based on another person’s experience.
Common Codeine Phosphate Side Effects
Like all medicines, codeine can cause side effects.
Common side effects include:
Constipation
Codeine can slow movement through the digestive system, making constipation a common opioid side effect.
If constipation becomes troublesome, speak with a pharmacist or doctor about appropriate measures.
Nausea and Vomiting
Some people may feel sick or be sick after taking codeine.
This may be more noticeable when treatment is first started.
Sleepiness or Tiredness
Codeine can make you feel sleepy or tired.
If this happens, avoid driving, cycling or operating machinery until you are confident that you can do so safely.
Sweating
Increased sweating is another recognised side effect of codeine.
Most side effects are manageable, but persistent or troublesome symptoms should be discussed with a healthcare professional.
Serious Side Effects of Codeine
Although uncommon, codeine can cause serious side effects.
These can include:
- Slow, weak or shallow breathing
- Severe dizziness
- Confusion
- Low blood pressure
- Serious allergic reactions
- Loss of consciousness
Difficulty breathing or severe respiratory depression requires urgent medical attention.
If someone taking codeine becomes difficult to wake or has severe breathing difficulties, call 999 for emergency assistance.
Can Codeine Phosphate Cause Dependence?
Yes.
Codeine is an opioid, and prolonged use can lead to tolerance and dependence. Some people may also develop addiction.
UK medicines safety guidance warns that opioid dependence can develop even when medicines are taken at therapeutic doses.
Potential warning signs include:
- Feeling that you need more medicine
- Craving codeine
- Taking more than prescribed
- Taking codeine for reasons other than pain
- Experiencing withdrawal symptoms when stopping
If you are concerned about dependence, speak with your GP or pharmacist.
What Is Codeine Tolerance?
With prolonged opioid treatment, the body can become accustomed to the medicine.
This is known as tolerance.
A person may notice that the same dose does not appear to provide the same level of pain relief as previously.
This does not mean that the answer is automatically to take more codeine.
Increasing opioid doses without medical supervision can increase the risk of adverse effects, dependence and overdose. GOV.UK specifically advises patients not to increase opioid doses or take extra opioid medicines without professional advice.
Codeine Phosphate and Alcohol
It is best to avoid alcohol while taking codeine unless your healthcare professional tells you otherwise.
Alcohol can increase the sedative effects of codeine and make side effects more likely.
Combining alcohol with an opioid can increase problems such as:
- Sleepiness
- Dizziness
- Reduced alertness
- Breathing difficulties
- Other serious opioid-related effects
If you are unsure about drinking alcohol during treatment, ask your pharmacist or doctor.
Can You Drive While Taking Codeine?
Codeine can make some people feel sleepy, tired or dizzy.
If you experience these effects, do not drive, cycle or operate machinery until you are no longer affected. NHS guidance specifically advises against driving when codeine causes sleepiness or tiredness.
Remember that feeling capable of driving is not necessarily the same as being legally or medically fit to drive.
If you are uncertain, seek professional advice.
Codeine Phosphate and Other Medicines
Before taking codeine, tell your doctor or pharmacist about all the medicines you use.
This includes:
- Prescription medicines
- Over-the-counter medicines
- Other painkillers
- Antidepressants
- Antihistamines
- Medicines for nausea
- Herbal remedies
- Vitamins and supplements
NHS guidance specifically identifies other opioid painkillers, including co-codamol, as medicines that may not mix well with codeine.
Do not combine opioid medicines to increase pain relief unless your doctor or pharmacist has specifically advised you to do so.
Codeine Phosphate and Co-codamol
This is particularly important for people who use different painkillers.
Co-codamol contains both paracetamol and codeine.
Taking additional codeine alongside co-codamol can increase the total amount of codeine you consume.
GOV.UK opioid safety advice says not to take additional opioid medicines to “top up” pain relief without advice from a prescriber or pharmacist.
If you already take co-codamol and have been prescribed codeine phosphate, check with your healthcare professional before taking them together.
Who May Need Extra Advice Before Taking Codeine?
Codeine may not be suitable for everyone.
Tell your doctor before treatment if you have:
- Breathing or lung problems
- Liver or kidney problems
- A head injury
- Low blood pressure
- An underactive thyroid
- Problems with your adrenal glands
- An enlarged prostate
- A previous history of dependence or addiction
- An allergy to codeine or another opioid
NHS guidance recommends discussing these conditions with a healthcare professional before taking codeine.
You should also tell your doctor if you are pregnant, trying to become pregnant or breastfeeding.
Codeine Phosphate During Pregnancy and Breastfeeding
If you are pregnant, planning a pregnancy or breastfeeding, speak with your healthcare professional before taking codeine.
Codeine may sometimes be used during pregnancy when clinically appropriate, but the benefits and potential risks should be assessed by a healthcare professional.
NHS guidance states that codeine is not usually used during breastfeeding because of the potential risk of side effects in the baby.
What Happens If You Take Too Much Codeine?
Taking more codeine than prescribed can be dangerous.
Possible symptoms can include:
- Extreme sleepiness
- Severe dizziness
- Confusion
- Slow or shallow breathing
- Loss of consciousness
NHS guidance advises contacting NHS 111 if you have taken more than your prescribed dose of codeine, even if you initially feel well.
If someone has severe breathing difficulties, becomes unconscious or cannot be woken, call 999 immediately.
Should You Stop Codeine Suddenly?
-
If you have been taking codeine regularly for a longer period, stopping suddenly may cause withdrawal symptoms.
Possible symptoms include:
- Anxiety
- Restlessness
- Sweating
- Difficulty sleeping
- Nausea
- Feeling agitated
NHS guidance recommends that people taking codeine for a long time should not stop suddenly. A doctor can gradually reduce the dose where appropriate.
If you want to stop treatment, discuss it with your prescriber first.
Codeine Phosphate 30mg and 60mg: Important Safety Tips
If you have been prescribed codeine phosphate:
- Follow your prescription exactly.
- Do not increase your dose yourself.
- Do not switch from 30mg to 60mg without medical advice.
- Do not share your medicine.
- Avoid alcohol unless your healthcare professional advises otherwise.
- Check before taking other painkillers.
- Tell your pharmacist about other medicines.
- Do not use codeine to help you sleep unless specifically prescribed for an appropriate medical reason.
- Do not stop long-term treatment suddenly.
- Store medicines safely away from children.
UK opioid safety guidance emphasises using opioids only as directed and not taking extra opioid medicines without advice.
When Should You Speak to a Doctor or Pharmacist?
Seek professional advice if:
- Your pain is getting worse.
- Your prescribed dose is no longer controlling your pain.
- You are experiencing persistent side effects.
- You are worried about dependence.
- You are considering stopping treatment.
- You take several medicines and are unsure about interactions.
- You accidentally take more than prescribed.
For severe breathing problems, loss of consciousness or another medical emergency, call 999.
Codeine Phosphate 30mg & 60mg: Key Takeaways
The most important points are:
- Codeine phosphate is an opioid painkiller.
- 30mg and 60mg are different tablet strengths.
- The appropriate strength depends on the individual prescription.
- Codeine can cause constipation, nausea, sleepiness and dizziness.
- Alcohol can increase the risk of side effects.
- Codeine can interact with other medicines, including other opioids.
- Long-term use can result in tolerance and dependence.
- Never increase the strength or dose without professional advice.
FAQ
What is codeine phosphate 30mg used for?
Codeine phosphate 30mg is an opioid painkiller that may be prescribed for certain types of pain when other painkillers have not provided sufficient relief.
What is the difference between codeine phosphate 30mg and 60mg?The main difference is the amount of codeine phosphate in each tablet. A 60mg tablet contains twice the amount of codeine phosphate found in a 30mg tablet. The appropriate strength depends on the individual prescription.
Is codeine phosphate 60mg stronger than 30mg?
Yes, a 60mg tablet contains twice as much codeine phosphate as a 30mg tablet. However, you should only take the strength prescribed for you and should never increase the dose yourself.
What are the common side effects of codeine phosphate?
Common side effects include constipation, nausea or vomiting, sleepiness, tiredness and sweating.
Can codeine phosphate cause dependence?
Yes. Codeine is an opioid and prolonged use can result in tolerance and dependence. Some people can also develop addiction.
Can you drink alcohol while taking codeine phosphate?
It is best to avoid alcohol because it can increase the risk of side effects and sedation.
Can you take codeine phosphate with co-codamol?
Do not combine codeine phosphate with co-codamol unless your doctor or pharmacist has specifically advised you to do so. Co-codamol already contains codeine.
Conclusion
Codeine phosphate 30mg and 60mg are opioid medicines that may be prescribed for certain types of pain when other painkillers have not provided sufficient relief. Although codeine can be effective when appropriately prescribed, it is important to understand its potential side effects, interactions and dependence risks.
The main difference between the two strengths is the amount of codeine phosphate contained in each tablet. However, 60mg should not be considered automatically better or more suitable than 30mg. The correct strength is determined by a healthcare professional based on the patient’s individual circumstances.
If you have questions about your codeine phosphate treatment, side effects, other medicines or how to safely stop treatment, speak with your GP or pharmacist.
