Does CBD Interact With Codeine (Codotab)?

Similar Medications: CBD & Opioid Painkillers

Codeine is classified as an opioid analgesic. CBD and opioid analgesics all share similar risks for interaction and side effects. It is used as an antitussive and as a mild pain reliever. 

Here’s a list of similar medications that share a similar level of risk when combined with CBD:

• Buprenorphine (Cizdol, Brixadi)
• Pethidine (Meperidine, Demerol)
• Fentanyl (Abstral, Actiq)
• Hydrocodone (Hysingla ER, Zohydro ER, Hycodan)
• Hydromorphone (Dilaudid)
• Methadone (Methadose, Dolophine)
• Morphine (Kadian, Roxanol)
• Oxycodone (Percodan, Endodan, Roxiprin, Percocet, Endocet, Roxicet, OxyContin)
• Tramadol (Ultram, Ryzolt, ConZip)

Is It Safe to Take CBD & Codeine (Codotab) Together?

CBD and codeine are considered safe when used within the recommended dosages for both substances. Long-term use of this combination or higher doses of either CBD or codeine isn’t considered safe. 

The interaction between codeine and CBD is considered mild.  

It’s recommended to take these two medicines together only under supervision and with caution. You should always talk with your medical practitioner if you want to start using CBD while using codeine. 

To further minimize risk, take CBD and codeine at least two hours apart from each other and avoid using this combination for more than two days in a row without a break. Limit the dose of both substances when using these compounds together for the first time to see how your body responds before taking a higher dose. 

Is CBD A Viable Alternative to Codeine?

In some cases, CBD may be a viable alternative to codeine. However, codeine is a much stronger analgesic, sedative, and cough suppressant for CBD. 

One study showed that CBD hemp extract could decrease pain in patients who have chronic pain and improve their quality of life [1]. It may be used as an alternative to the possible addiction-forming pain relievers like opioid analgesics. 

CBD has anti-inflammatory and antioxidant properties [2]. So it may be possible to use it in conditions that codeine and other opioid analgesics are used in. 

However, while delta 9 tetrahydrocannabinol (THC), another cannabinoid from the cannabis plant, is shown to be effective in decreasing cough, CBD itself does not show such effects [3]. 

CBD has shown to have enough potential to become a good pain reliever and may even replace opioids like codeine for mild to moderate pain.

What is Codeine (Codotab)?

Codeine is a narcotic pain reliever and a cough suppressant. It’s a prodrug of morphine and belongs to the opioid family of drugs. It has sedative properties and can also depress respiratory function and treat diarrhea. 

It may be more effective when combined with another drug called acetaminophen. 

Codeine Specs:

What Does Codeine (Codotab) Do?

Codeine is a type of opioid. It acts on the central nervous system and has an analgesic effect. It’s metabolized in the liver to produce morphine. 

Opioids bind to specific opioid receptors in the nervous system. There are three main classes of opioid receptors called μ, κ, δ (mu, kappa, and delta). The abilities of an opioid depend on the receptor that it binds to. Each group of opioid receptors evokes a particular set of neurological responses. These receptors mediate both the psychoactive and the somatic effects of opioids. Opioid receptors are G-protein coupled receptors that positively and negatively regulate synaptic transmission through downstream signaling. 

Codeine is a selective agonist for the mu receptor, similar to another potent opioid morphine. But codeine has a much weaker affinity to this receptor than morphine. 

Codeine or morphine can bind to the mu receptor and result in the hyperpolarization of the neuron. This action leads to the inhibition of the release of nociceptive neurotransmitters, causing an analgesic effect and increased pain tolerance due to reduced neuronal excitability. 

When the opioids attach to their respective receptors, they block the pain signals sent from various parts of the body through the spinal cord to the brain. They also trigger the brain to release dopamine, the feel-good hormone. It means every time you take codeine, it can cause some sedation and give relief from the pain combined with the sense of wellbeing and euphoria. This can cause this drug to become addictive. 

So using it for a long time may cause a person to develop tolerance, provoking them to consume even more of the drug. Stopping codeine abruptly may cause withdrawal-like symptoms. Too much usage of codeine can develop tolerance, which might lead to the users seeking stronger drugs. 

At lower doses, codeine can make the person feel drowsy. But higher doses can slow down the breathing and heart rate, which could be dangerous. 

Codeine is not allowed for use in children less than 12 years of age. It can be used in pregnancy only under the supervision of the prescribing physician. Codeine can be used during pregnancy only if the potential benefit outweighs the potential risk of the drug to the fetus. Prolonged use of codeine in pregnancy can result in neonatal opioid withdrawal syndrome, which may be life-threatening if not recognized and treated. 

Because of its addictive nature, the use of codeine must be done with caution. Use of codeine with benzodiazepines and other central nervous systems (CNS) depressants, including alcohol, may result in extreme sedation, respiratory depression, and coma.

Side Effects of Codeine (Codotab)

• Pruritus
• Vomiting 
• Constipation 
• Confusion
• Gastrointestinal disturbance
• Hypotension
• Headache 
• Somnolence 
• Abdominal pain 
• Asthenia 
• Depression 
• Diarrhea 
• Fever
• Anorexia
• Dry mouth
• Excess sweating
• Loss of appetite 
• Nausea 
• Peripheral edema 
• Rash 
• Sweating 
• Respiratory depression
• Anxiety
• Dizziness 
• Hypersensitivity

Other Names For Codeine (Codotab)

Codeine is sold under many different names. All share the same risk and potential interactions.

Other names for Codeine include:

• Cetcod
• Code P
• Codmine
• Codophos
• Codetol
• Nikodin
• Cotabflu
• Cotabflu
• Colrex
• Fioricet with Codeine
• Phrenilin with Caffeine and Codeine
• Ascomp
• Cheratussin
• Codar Ar
• Codar D
• Codar Gf
• Codeine Contin
• Covan
• Damylin With Codeine

Key Takeaways: Is it Safe to Take Codeine (Codotab) With CBD?

CBD can slow down the metabolism of codeine in the body and lead to an increased risk of side effects. 

However, this combination is considered mild, and the chances of experiencing adverse reactions are low. 

Despite the lower risk, codeine and CBD may lead to increased side effects, some of which can be severe. Because of this, it’s wise to speak to a medical professional before taking CBD alongside codeine for any reason. 

Using CBD as a potentiator for codeine, especially in higher doses, can be extremely dangerous. 

References

1. Capano, A., Weaver, R., & Burkman, E. (2020). Evaluation of the effects of CBD hemp extract on opioid use and quality of life indicators in chronic pain patients: a prospective cohort study. Postgraduate medicine, 132(1), 56-61. 
2. Atalay, S., Jarocka-Karpowicz, I., & Skrzydlewska, E. (2020). Antioxidative and anti-inflammatory properties of cannabidiol. Antioxidants, 9(1), 21. 
3. Gordon, R., Gordon, R. J., & Sofia, R. D. (1976). Antitussive activity of some naturally occurring cannabinoids in anesthetized cats. European journal of pharmacology, 35(2), 309-313.