*Welcome to the OutUK series looking at gay men and their health brought to you in association with the NHS* website.**
	Each week we'll tackle a different topic in our A to Z of Gay Health. We'll have features and advice on everything from relationships, sexual health, mental and physical conditions and how to stay fit. You can follow any of links provided below for more information direct from the NHS website, or see this week's feature M: MRSA.

How And When To Take Codeine

NHS medicines information on dosage for codeine, how to take it and what to do if you miss a dose or take too much.

Follow your doctor's instructions about how to take this medicine. This is particularly important because codeine can be addictive.

Dosage and strength

Codeine comes as:

tablets - these contain 15mg, 30mg or 60mg of codeine
a liquid that you swallow - this contains 25mg of codeine in a 5ml spoonful
cough syrup - this contains 15mg of codeine in a 5ml spoonful
an injection (usually given in hospital)

The usual dose of codeine is 15mg to 60mg.

The usual dose for treating pain is:

adults - one or two 30mg tablets, taken every 4 hours, up to a maximum of 8 tablets (240mg) in 24 hours
children (aged 12 to 17 years) - one or two 30mg tablets (or one or two 5ml spoonfuls of liquid), taken every 6 hours
older people or people with kidney or liver problems - one 15mg tablet, taken every 4 hours

The usual dose for treating diarrhoea is:

adults - one or two 30mg tablets (or one or two 5ml spoonfuls of liquid)
children (aged 12 to 17 years) - one or two 30mg tablets (or one or two 5ml spoonfuls of liquid)
older people, or people with kidney or liver problems - one 15mg tablet

You can take this dose 3 or 4 times a day.

The usual dose for treating a cough is:

adults and children - one or two 5ml spoonfuls of cough syrup, taken 3 or 4 times a day

It's important not to take more than your prescribed dose. Do not take more than 4 doses of codeine in 24 hours if you're:

a child (aged 12 to 17 years)
taking a 60mg dose

Changes to your dose

If you get side effects from taking codeine, your doctor may lower your dose.

If your symptoms do not go away, your doctor may increase your dose or prescribe a different medicine.

Talk to your doctor if your pain or diarrhoea is not relieved by the dose of codeine prescribed for you, or if side effects bother you or do not go away.

How to take it

Swallow your codeine tablet whole with a drink of water. Take it with, or just after, a meal or snack so it's less likely to make you feel sick.

You can take codeine at any time of day but try to take it at the same times every day, and space your doses evenly.

If you're taking codeine as a liquid, it will come with a plastic spoon or syringe to help you measure the correct amount. Ask your pharmacist for one if you do not have it. Do not measure the liquid with a kitchen teaspoon because it will not give the right amount.

How long to take it for

You might only need to take codeine for a few days. Sometimes, you may need to take it for longer. But usually, a different medicine will be prescribed for long-term pain or diarrhoea, especially if you have side effects like constipation.

If you forget to take it

If you forget to take a dose, check the information on the leaflet inside the packaging, or ask your pharmacist or doctor for advice on what to do.

Never take 2 doses at the same time to make up for a forgotten one.

If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to remember your medicine.

If you take too much

It's important not to take more than your prescribed dose, even if you think it's not enough to relieve your pain. Speak to your doctor first, if you think you need a different dose.

Taking too much codeine can be dangerous. It may make you feel very sleepy, sick or dizzy. You may also find it difficult to breathe. In serious cases, you can become unconscious and may need emergency treatment in hospital.

The amount of codeine that can lead to an overdose varies from person to person.

Contact 111 for advice now if:

you've taken more than your recommended dose of codeine

Go to 111.nhs.uk or call 111.

If you need to go to A&E, do not drive yourself. Get someone else to drive you or call for an ambulance. Take the codeine box or leaflet inside, plus any remaining medicine with you.

Call 999 or go to A&E now if:

you have taken more than your recommended dose of codeine and are having problems with your breathing

Find your nearest A&E

Call 999 now if:

you are losing consciousness - if you're with someone, ask them to call for you

Stopping codeine

If you have been taking codeine for a long time and want to stop, talk to your doctor first. Your dose can be reduced gradually so you do not get withdrawal symptoms. If you stop taking it suddenly, it can cause:

agitation
anxiety
shaking
sweating

Important

If you have been taking codeine for more than a few weeks, do not stop taking it without speaking to your doctor first.

Storing codeine

If you've been prescribed codeine, it's particularly important to:

store it properly and safely at home
keep it out of the sight and reach of children
never share your medicine with anyone else

Return any unused codeine to your pharmacist. They will get rid of it.

OutUK's A to Z of Gay Health continues and you can read this week's feature M: MRSA. We have covered many subjects in this series and you can catch up with all of our Previous A to Z Features. If you want to find out more about this particular topic you can visit the Original article on the NHS website. If you are worried by any aspect of your health make sure you go and see your doctor or book an appointment at your local clinic.
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