{"id":8107,"date":"2026-04-26T23:21:05","date_gmt":"2026-04-26T23:21:05","guid":{"rendered":"https:\/\/bristishpharmacy.co.uk\/?post_type=product&#038;p=8107"},"modified":"2026-09-16T10:47:15","modified_gmt":"2026-09-16T10:47:15","slug":"codeine-fosfaat","status":"publish","type":"product","link":"https:\/\/bristishpharmacy.co.uk\/nl\/shop\/codeine-fosfaat\/","title":{"rendered":"Code\u00efnefosfaat"},"content":{"rendered":"<h1>\u00a0<\/h1>\n<div class=\"container\">\n<div id=\"model-response-message-contentr_d0cc195158c367f5\" class=\"markdown markdown-main-panel md-content enable-luminous-fast-follows enable-updated-hr-color stronger tutor-markdown-rendering\" dir=\"ltr\" aria-live=\"polite\">\n<h3 data-path-to-node=\"3\">Clinical Monograph: Codeine Phosphate<\/h3>\n<div class=\"attachment-container search-images\">\n<div class=\"image-container spark-licensed-center hide-from-message-actions ng-star-inserted\" data-full-size-image-uri=\"https:\/\/cdn11.bigcommerce.com\/s-n6ynrx6s4d\/images\/stencil\/500x500\/products\/1115\/3378\/codeine_phos_30mg__63658.1648237492.jpg?c=1\">\n<div class=\"overlay-container hero-overlay-container ng-star-inserted\"><button class=\"image-button ng-star-inserted\"><img fetchpriority=\"high\" decoding=\"async\" class=\"spark-licensed-square hero-image loaded\" src=\"https:\/\/encrypted-tbn0.gstatic.com\/images?q=tbn:ANd9GcQGXoqcEbo8g_57WX99iEPLKNpoa-2H1-hjAAzjk1Dr1SxjlgzwIv0qiaIM&amp;s=10\" alt=\"Codeine phosphate 30 mg tablet box, AI generated\" width=\"316\" height=\"316\" \/><\/button><\/p>\n<div class=\"hero-caption-row ng-star-inserted\">\n<div class=\"caption gds-extended-caption hero-caption ng-star-inserted\" aria-hidden=\"true\">Codeine phosphate 30 mg tablet box. <span class=\"ng-star-inserted\">Source: Hyperdrug<\/span><\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<h2 data-path-to-node=\"5\">1. Classification and Chemical Overview<\/h2>\n<p data-path-to-node=\"6\">Codeine (3-methylmorphine) is a naturally occurring phenanthrene alkaloid obtained from the opium poppy (<i data-path-to-node=\"6\" data-index-in-node=\"105\">Papaver somniferum<\/i>) or synthesized via <span class=\"math-inline\" data-math=\"O\" data-index-in-node=\"144\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">O<\/span><\/span><\/span><\/span><\/span>-methylation of morphine. Codeine phosphate is the hemihydrate salt of codeine, designated chemically as 7,8-didehydro-4,5$\\alpha$-epoxy-3-methoxy-17-methylmorphinan-6$\\alpha$-ol phosphate. Under the Anatomical Therapeutic Chemical (ATC) classification system, codeine is indexed under N02AA59 (analgesics) and R05DA04 (cough suppressants).<\/p>\n<p data-path-to-node=\"7\">Codeine phosphate is classified as a Controlled Substance internationally (e.g., Schedule II, III, or V depending on formulation strength and presence of co-analgesics under the US Controlled Substances Act; Class B \/ Schedule 2 Controlled Drug in the UK). It is regulated strictly as a Prescription Only Medicine (POM) when prescribed as a single entity.<\/p>\n<h2 data-path-to-node=\"8\">2. Mechanism of Action and Pharmacodynamics<\/h2>\n<p data-path-to-node=\"9\">Codeine exhibits weak intrinsic affinity for opioid receptors; its therapeutic efficacy depends on metabolic activation:<\/p>\n<ul data-path-to-node=\"10\">\n<li>\n<p data-path-to-node=\"10,0,0\"><b data-path-to-node=\"10,0,0\" data-index-in-node=\"0\">Prodrug Activation:<\/b> Codeine undergoes biotransformation into morphine, which acts as a full agonist at central <span class=\"math-inline\" data-math=\"\\mu\" data-index-in-node=\"111\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">\u03bc<\/span><\/span><\/span><\/span><\/span>-opioid receptors.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"10,1,0\"><b data-path-to-node=\"10,1,0\" data-index-in-node=\"0\">Analgesic Signaling:<\/b> Active morphine binding inhibits adenylyl cyclase activity, hyperpolarizes neurons via potassium channel activation, and closes presynaptic voltage-gated calcium channels. This blocks the transmission of nociceptive impulses in the spinal cord dorsal horn and periaqueductal gray.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"10,2,0\"><b data-path-to-node=\"10,2,0\" data-index-in-node=\"0\">Antitussive Mechanism:<\/b> Direct suppression of the medullary cough center in the brainstem, reducing the sensitivity of the cough reflex arc to respiratory tract stimulation.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"11\">3. Approved Clinical Indications and Dosing Scope<\/h2>\n<p data-path-to-node=\"12\">Licensing for codeine phosphate includes:<\/p>\n<ul data-path-to-node=\"13\">\n<li>\n<p data-path-to-node=\"13,0,0\"><b data-path-to-node=\"13,0,0\" data-index-in-node=\"0\">Mild-to-Moderate Pain:<\/b> Relief of acute, mild-to-moderate pain not adequately managed by non-opioid analgesics (e.g., paracetamol or ibuprofen) alone.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"13,1,0\"><b data-path-to-node=\"13,1,0\" data-index-in-node=\"0\">Antitussive Management:<\/b> Short-term symptomatic relief of dry, non-productive cough in adults.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"13,2,0\"><b data-path-to-node=\"13,2,0\" data-index-in-node=\"0\">Diarrhea Management:<\/b> Symptomatic relief of acute diarrhea in adults (uncommon secondary indication).<\/p>\n<\/li>\n<\/ul>\n<p data-path-to-node=\"14\"><i data-path-to-node=\"14\" data-index-in-node=\"0\">Dosing &amp; Administration Regimen:<\/i><\/p>\n<ul data-path-to-node=\"15\">\n<li>\n<p data-path-to-node=\"15,0,0\"><b data-path-to-node=\"15,0,0\" data-index-in-node=\"0\">Adult Analgesia:<\/b> Typically 30 mg to 60 mg orally every 4 to 6 hours as needed (maximum daily dose: 240 mg).<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"15,1,0\"><b data-path-to-node=\"15,1,0\" data-index-in-node=\"0\">Shortest Effective Duration:<\/b> Therapy should be limited to the lowest effective dose for the shortest possible duration (generally <span class=\"math-inline\" data-math=\"\\le 3\\text{ days}\" data-index-in-node=\"130\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">\u2264<\/span><\/span><span class=\"base\"><span class=\"mord\">3<\/span><span class=\"mord text\"><span class=\"mord\">\u00a0days<\/span><\/span><\/span><\/span><\/span><\/span> for acute pain) to minimize tolerance and physical dependence.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"16\">4. Pharmacokinetic Profile and Metabolic Fate<\/h2>\n<ul data-path-to-node=\"17\">\n<li>\n<p data-path-to-node=\"17,0,0\"><b data-path-to-node=\"17,0,0\" data-index-in-node=\"0\">Absorption:<\/b> Rapidly absorbed from the gastrointestinal tract with oral bioavailability of approximately 60% to 70%. Peak plasma concentrations (<span class=\"math-inline\" data-math=\"C_{max}\" data-index-in-node=\"144\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord\"><span class=\"mord mathnormal\">C<\/span><span class=\"msupsub\"><span class=\"vlist-t vlist-t2\"><span class=\"vlist-r\"><span class=\"vlist\"><span class=\"\"><span class=\"sizing reset-size6 size3 mtight\"><span class=\"mord mtight\"><span class=\"mord mathnormal mtight\">ma<\/span><span class=\"mord mathnormal mtight\">x<\/span><\/span><\/span><\/span><\/span><span class=\"vlist-s\">\u200b<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span>) occur within 1 hour (<span class=\"math-inline\" data-math=\"T_{max}\" data-index-in-node=\"174\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord\"><span class=\"mord mathnormal\">T<\/span><span class=\"msupsub\"><span class=\"vlist-t vlist-t2\"><span class=\"vlist-r\"><span class=\"vlist\"><span class=\"\"><span class=\"sizing reset-size6 size3 mtight\"><span class=\"mord mtight\"><span class=\"mord mathnormal mtight\">ma<\/span><span class=\"mord mathnormal mtight\">x<\/span><\/span><\/span><\/span><\/span><span class=\"vlist-s\">\u200b<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span>).<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"17,1,0\"><b data-path-to-node=\"17,1,0\" data-index-in-node=\"0\">Distribution:<\/b> Protein binding is low (~7% to 25%). Crosses the blood-brain barrier, placenta, and enters human breast milk.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"17,2,0\"><b data-path-to-node=\"17,2,0\" data-index-in-node=\"0\">Biotransformation:<\/b> Extensively metabolized in the liver via Cytochrome P450 enzymes:<\/p>\n<ul data-path-to-node=\"17,2,1\">\n<li>\n<p data-path-to-node=\"17,2,1,0,0\"><b data-path-to-node=\"17,2,1,0,0\" data-index-in-node=\"0\">CYP2D6 Pathway (Essential for Analgesia):<\/b> <span class=\"math-inline\" data-math=\"O\" data-index-in-node=\"42\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">O<\/span><\/span><\/span><\/span><\/span>-demethylation converts ~5% to 10% of codeine into <b data-path-to-node=\"17,2,1,0,0\" data-index-in-node=\"94\">morfine<\/b>, the primary mediator of its analgesic potency.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"17,2,1,1,0\"><b data-path-to-node=\"17,2,1,1,0\" data-index-in-node=\"0\">CYP3A4 Pathway:<\/b> <span class=\"math-inline\" data-math=\"N\" data-index-in-node=\"16\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord mathnormal\">N<\/span><\/span><\/span><\/span><\/span>-demethylation to norcodeine.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"17,2,1,2,0\"><b data-path-to-node=\"17,2,1,2,0\" data-index-in-node=\"0\">UGT2B7 Pathway (Major):<\/b> Glucuronidation to codeine-6-glucuronide (~50% to 70%).<\/p>\n<\/li>\n<\/ul>\n<\/li>\n<li>\n<p data-path-to-node=\"17,3,0\"><b data-path-to-node=\"17,3,0\" data-index-in-node=\"0\">Elimination:<\/b> Excreted almost exclusively by the kidneys in urine as glucuronide conjugates and parent compound. Plasma elimination half-life (<span class=\"math-inline\" data-math=\"t_{1\/2}\" data-index-in-node=\"142\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mord\"><span class=\"mord mathnormal\">t<\/span><span class=\"msupsub\"><span class=\"vlist-t vlist-t2\"><span class=\"vlist-r\"><span class=\"vlist\"><span class=\"\"><span class=\"sizing reset-size6 size3 mtight\"><span class=\"mord mtight\">1\/2<\/span><\/span><\/span><\/span><span class=\"vlist-s\">\u200b<\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span><\/span>) is approximately 2.5 to 3.5 hours.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"18\">5. Physiological Effects and Adverse Event Spectrum<\/h2>\n<p data-path-to-node=\"19\">Codeine depresses central nervous system functions, decreases gastrointestinal motility, and dampens the respiratory drive.<\/p>\n<h3 data-path-to-node=\"20\">Adverse Drug Reaction Spectrum<\/h3>\n<ul data-path-to-node=\"21\">\n<li>\n<p data-path-to-node=\"21,0,0\"><b data-path-to-node=\"21,0,0\" data-index-in-node=\"0\">Very Common (<span class=\"math-inline\" data-math=\"\\ge 1\/10\" data-index-in-node=\"13\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">\u2265<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/10<\/span><\/span><\/span><\/span><\/span>):<\/b> Constipation, somnolence, nausea.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"21,1,0\"><b data-path-to-node=\"21,1,0\" data-index-in-node=\"0\">Common (<span class=\"math-inline\" data-math=\"\\ge 1\/100\" data-index-in-node=\"8\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">\u2265<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/100<\/span><\/span><\/span><\/span><\/span> to <span class=\"math-inline\" data-math=\"&lt;1\/10\" data-index-in-node=\"21\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">&lt;<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/10<\/span><\/span><\/span><\/span><\/span>):<\/b> Vomiting, dizziness, lightheadedness, dry mouth, sweating, confusion, headache.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"21,2,0\"><b data-path-to-node=\"21,2,0\" data-index-in-node=\"0\">Uncommon (<span class=\"math-inline\" data-math=\"\\ge 1\/1,000\" data-index-in-node=\"10\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">\u2265<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/1<\/span><span class=\"mpunct\">,<\/span><span class=\"mord\">000<\/span><\/span><\/span><\/span><\/span> to <span class=\"math-inline\" data-math=\"&lt;1\/100\" data-index-in-node=\"25\"><span class=\"katex\"><span class=\"katex-html\" aria-hidden=\"true\"><span class=\"base\"><span class=\"mrel\">&lt;<\/span><\/span><span class=\"base\"><span class=\"mord\">1\/100<\/span><\/span><\/span><\/span><\/span>):<\/b> Miosis, ureteral or biliary spasm, urinary retention, euphoria, dysphoria, pruritus, rash, orthostatic hypotension.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"21,3,0\"><b data-path-to-node=\"21,3,0\" data-index-in-node=\"0\">Rare \/ Severe (&lt;1\/1,000):<\/b> Severe respiratory depression, hallucinations, dependence\/withdrawal syndrome, anaphylaxis, paralytic ileus.<\/p>\n<\/li>\n<\/ul>\n<h2 data-path-to-node=\"22\">6. Contraindications, Drug Interactions, and Clinical Precautions<\/h2>\n<h3 data-path-to-node=\"23\">Contra-indicaties<\/h3>\n<ul data-path-to-node=\"24\">\n<li>\n<p data-path-to-node=\"24,0,0\">Known hypersensitivity to codeine or other opioids.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,1,0\"><b data-path-to-node=\"24,1,0\" data-index-in-node=\"0\">Ultra-Rapid CYP2D6 Metabolizers:<\/b> Individuals with CYP2D6 gene duplications convert codeine to morphine rapidly and unpredictably, leading to potentially fatal morphine toxicity.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,2,0\">Children under 12 years of age (contraindicated for all indications due to fatal respiratory risks).<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,3,0\">Children aged 12 to 18 years undergoing tonsillectomy or adenoidectomy for obstructive sleep apnea.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,4,0\">Compromised respiratory function, acute severe asthma, or acute respiratory depression.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"24,5,0\">Lactating women (risk of passing toxic morphine levels to the nursing infant).<\/p>\n<\/li>\n<\/ul>\n<h3 data-path-to-node=\"25\">Key Drug Interactions<\/h3>\n<ul data-path-to-node=\"26\">\n<li>\n<p data-path-to-node=\"26,0,0\"><b data-path-to-node=\"26,0,0\" data-index-in-node=\"0\">CYP2D6 Inhibitors (e.g., Fluoxetine, Paroxetine, Bupropion, Quinidine):<\/b> Block the conversion of codeine to active morphine, significantly reducing or abolishing analgesic efficacy.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"26,1,0\"><b data-path-to-node=\"26,1,0\" data-index-in-node=\"0\">CYP3A4 Inhibitors &amp; Inducers:<\/b> Alter clearance pathways, modifying circulating levels of active metabolites.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"26,2,0\"><b data-path-to-node=\"26,2,0\" data-index-in-node=\"0\">CNS Depressants, Benzodiazepines, &amp; Alcohol:<\/b> Synergistic central nervous system depression markedly elevates the risk of profound sedation, life-threatening respiratory depression, coma, and death.<\/p>\n<\/li>\n<\/ul>\n<h3 data-path-to-node=\"27\">Clinical Precautions and Monitoring<\/h3>\n<ul data-path-to-node=\"28\">\n<li>\n<p data-path-to-node=\"28,0,0\"><b data-path-to-node=\"28,0,0\" data-index-in-node=\"0\">Boxed Warning (Ultra-Rapid Metabolism &amp; Death in Children):<\/b> Respiratory depression and death have occurred in children receiving codeine following surgery. Ultra-rapid metabolizers carry high risk at any age.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"28,1,0\"><b data-path-to-node=\"28,1,0\" data-index-in-node=\"0\">Pharmacogenomic Variability:<\/b> CYP2D6 poor metabolizers experience minimal pain relief, while ultra-rapid metabolizers risk severe toxicity even at normal therapeutic doses.<\/p>\n<\/li>\n<li>\n<p data-path-to-node=\"28,2,0\"><b data-path-to-node=\"28,2,0\" data-index-in-node=\"0\">Dependence and Tolerance:<\/b> Continuous use leads to physical and psychological dependence. Abrupt discontinuation precipitates an opioid withdrawal syndrome (restlessness, lacrimation, rhinorrhea, abdominal cramps, diaphoresis).<\/p>\n<\/li>\n<\/ul>\n<\/div>\n<\/div>\n\n    <div class=\"xs_social_share_widget xs_share_url after_content \t\tmain_content  wslu-style-1 wslu-share-box-shaped wslu-fill-colored wslu-none wslu-share-horizontal wslu-theme-font-no wslu-main_content\">\n\n\t\t\n        <ul>\n\t\t\t        <\/ul>\n    <\/div>","protected":false},"excerpt":{"rendered":"<p data-path-to-node=\"1\">Codeine phosphate is a relatively weak, centrally acting opioid analgesic and antitussive. It functions primarily as a prodrug, undergoing hepatic metabolic conversion into morphine to relieve mild-to-moderate pain and suppress non-productive cough.<\/p>\n<h3 data-path-to-node=\"3\">\u00a0<\/h3>","protected":false},"featured_media":8108,"comment_status":"closed","ping_status":"closed","template":"","meta":{"postBodyCss":"","postBodyMargin":[],"postBodyPadding":[],"postBodyBackground":{"backgroundType":"classic","gradient":""}},"product_brand":[],"product_cat":[15],"product_tag":[245],"class_list":["post-8107","product","type-product","status-publish","has-post-thumbnail","product_cat-uncategorized","product_tag-codeine-phosphate","instock","shipping-taxable","purchasable","product-type-simple"],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v26.5 (Yoast SEO v28.5) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Codeine Phosphate - British Pharmacy<\/title>\n<meta name=\"description\" content=\"Codeine phosphate is the phosphate salt form of codeine, a naturally occurring opioid alkaloid derived from the opium poppy plant (Papaver somniferum)\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/bristishpharmacy.co.uk\/nl\/shop\/codeine-fosfaat\/\" \/>\n<meta property=\"og:locale\" content=\"nl_NL\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Codeine Phosphate\" \/>\n<meta property=\"og:description\" content=\"Codeine phosphate is a relatively weak, centrally acting opioid analgesic and antitussive. 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