Codeine (Tricodein, Codicaps)

<p>From: Reviving the Broken Marionette: Treatments for CFS/ME and Fibromyalgia

Codeine is a pro–drug that undergoes a conversion into morphine in the liver. It is used to treat chronic pain of mild to moderate severity and may also be useful for IBS. The duration of action is nonetheless short and the efficacy only increases to a certain point (60 mg), after which increasing the dose confers no benefit (ceiling effect). According to Dr. Mark Pellegrino many people with fibromyalgia are sensitive to codeine and may also react to tramadol.28

Paroxetine, fluoxetine and some other drugs inhibit the conversion of codeine to morphine and thus make the drug all but ineffective. Up to 10% of Caucasians cannot perform this metabolic step in the first place, and are thus resistant to the effects of codeine.

Codeine is widely available in tablets and liquid formulations, though in most countries it is only available in combination products with other analgesics and sometimes caffeine. In the United Kingdom, Canada and some other countries such preparations containing low doses of codeine may be dispensed without prescription. In the United States codeine is a Schedule II, III or IV drug depending on the formulation.

Codeine cough syrups are commonly sold over the counter in many places (including the United States), but they should not be used for the relief of chronic pain. Modified release preparations of codeine are available in some countries, but not in the United States. Codeine is inexpensive.

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