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A pharmaceutical expert has sounded an alert over a popular type of painkiller taken by millions of people in the UK every week that can cause serious withdrawal symptoms when stopped, including sweating, sleeplessness and anxiety. Codeine-based painkillers are opioid medications used for short-term, moderate pain relief when non-opioids like ibuprofen or paracetamol fail.

The works in the central nervous system and the brain to block pain signals to the rest of the body. It also reduces the anxiety and stress caused by pain.

Now in a new article on The Conversation, Dipa Kamdar Senior Lecturer in Pharmacy Practice, Kingston University, said people need to be wary of a number of symptoms. She explained: “Many people assume that medicines sold over the counter are inherently safe. After all, if you can buy something in a supermarket or high street pharmacy, how dangerous can it really be?

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“The reality is more complicated. Several commonly used over-the-counter medicines carry a real risk of dependence, misuse or harm when taken in higher than recommended doses, for longer than needed, or for the wrong reasons. Here are five medicines it is worth knowing about.”

Speaking about codeine-based painkillers she said some side-effects could impact people of certain backgrounds more than others and make it more dangerous for activities such as driving. She added there is a ‘three day rule’ for most people taking the drug with experts saying it should be taken for ‘as little time as possible.’

Ms Kamdar said: “Codeineis an opioid medicine used to treat mildto moderate pain and, in some formulations, to suppress coughing. Over the counter, it is usually combined with either ibuprofen or paracetamol. Once swallowed, the body converts codeine into morphine, which produces its pain-relieving effects.

”Common side effects include drowsiness, constipation, nausea and dizziness. At higher doses, codeine can slow breathing and impair coordination. Some people are particularly vulnerable. Ultra-rapid metabolisers carry a genetic variant that causes them to convert codeine into morphine much faster than usual. This trait is more common in people of North African, Middle Eastern and Oceanian backgrounds and can lead to dangerous side effects even at standard doses.

“With repeated use, the body can also become tolerant to codeine, meaning the same dose no longer provides the same relief. This process, known as tolerance, occurs as the brain’s opioid receptors adapt to the drug. People may then increase their dose, raising the risk of physical dependence. Stopping suddenly can cause withdrawal symptoms such as anxiety, restlessness, sweating and sleep problems.

“To reduce these risks, codeine should be used for the shortest time possible. In the UK, the Medicines and Healthcare products Regulatory Agency limits pack sizes to 32 tablets and advises non-prescription products should be used for no more than three days.”

• The most common side effects of codeine are constipation, feeling sick (nausea) and feeling sleepy.
• It's possible to become addicted to codeine, but your doctor will explain how to reduce the risks of this happening.
• If you need to take codeine for more than a few weeks, your treatment plan may include details of how and when to stop taking this medicine.
• It may be best not to drink alcohol while taking codeine as you're more likely to get side effects like feeling sleepy.
• Do not give codeine to children under 12. Only give codeine to children aged 12 to 18 if everyday painkillers, like paracetamol and ibuprofen, have not worked.

For more information from the NHS click here. To read the full article on The Conversation click here.

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