Codeine

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Date: August 2022, Version 4

What is it?

Codeine is used to relieve pain and to prevent coughing. It can be prescribed or bought over the counter in combination with other painkillers.

Benefits

What are the benefits of taking codeine in pregnancy?

Codeine can provide effective pain relief and sometimes works where other painkillers have not. If codeine is prescribed in pregnancy, this is because a doctor thinks that its use is important for a pregnant woman’s quality of life. Please do not use codeine in pregnancy unless it has been prescribed.

Risks

Are there any risks of taking codeine during pregnancy?

While it is clear that the majority of babies born to women taking codeine do not experience any long-term effects, some studies have shown that, very occasionally, codeine use in early pregnancy may be linked to heart defects and spina bifida in the baby. Further research is required to confirm these links.

Codeine used around the time of delivery can affect the baby for a while after birth, meaning that they may need to be looked after in a neonatal unit. The baby may be ‘jittery’, have feeding problems, and initially need some help with breathing. These problems usually settle within the first few days.

Alternatives

Are there any alternatives to taking codeine?

Yes; other painkillers can be safely used in pregnancy but may not provide the same level of pain relief as codeine. Chronic pain can sometimes be improved with talking therapies; however, this does not work for everyone and some people may need or prefer to take a medicine.

Women using codeine who become pregnant or who are planning a pregnancy should consult their doctor or specialist so that their medication and dosage can be reviewed, and the risks and benefits of changing to something else can be weighed up. If you are using codeine long-term, please do not stop taking it or change the dose without speaking to a healthcare professional.

No treatment

What if I prefer not to take codeine during pregnancy?

Severe and/or chronic pain can greatly affect quality of life. If your doctor suggests that you consider taking codeine in pregnancy they will help you to weigh up whether any possible risks are outweighed by the benefits of your pain being well-controlled.

Will my baby need extra monitoring?

You will be offered a very detailed scan at around 20 weeks of pregnancy as part of your routine antenatal care. Taking codeine in pregnancy is not expected to cause problems that would require any extra monitoring of your baby prior to birth.

Babies who have been exposed to codeine in the womb around the time of delivery may be more closely monitored for a while after birth to ensure that they are breathing and feeding as normal.

Are there any risks to my baby if the father has taken codeine?

We would not expect any increased risk to your baby if the father takes codeine. 

Who can I talk to if I have questions?

If you have any questions about the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org

How can I help to improve drug safety information for pregnant women in the future?

Our online reporting system (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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