Codeine in Pregnancy — Is It Safe?
Last reviewed: · Source: US FDA drug label database
This page contains affiliate links through Amazon and CJ Affiliate. As an Amazon Associate we earn from qualifying purchases. We may earn a commission if you buy through them, at no extra cost to you.
Avoid codeine in pregnancy — it can cause neonatal opioid withdrawal syndrome and respiratory depression in the newborn if used near delivery.
Confirm parentage with confidence — order a DNA test at Paternity Lab →
- The FDA has specifically warned against codeine use in pregnant and breastfeeding women.
- Used near delivery, it can cause respiratory depression and neonatal opioid withdrawal syndrome (NOWS) in the newborn.
- Some women are ultra-rapid metabolisers who convert codeine to morphine quickly, leading to unpredictably high morphine levels that affect the baby.
- If you need pain relief in pregnancy, discuss safer alternatives with your midwife or GP rather than using codeine, especially in the third trimester.
Is it safe to take Codeine with Pregnancy?
Codeine should be avoided in pregnancy, particularly in the third trimester and near delivery. It crosses the placenta and can cause respiratory depression in the newborn and neonatal opioid withdrawal syndrome (NOWS). In some women, codeine is rapidly converted to morphine (ultra-rapid metabolisers), leading to dangerously high morphine levels in breast milk or, during pregnancy, in the fetus. Paracetamol is the recommended painkiller in pregnancy.
How do Codeine and Pregnancy interact?
Codeine is a prodrug converted to morphine by CYP2D6 in the liver. Morphine crosses the placenta and activates fetal opioid receptors. Prolonged fetal opioid exposure leads to physical dependence, which manifests as NOWS after birth. Third-trimester use is particularly concerning as the fetal respiratory centre is more susceptible to opioid-induced depression. The FDA warns specifically against codeine in pregnancy.
Data sourced from the US Food and Drug Administration (FDA) drug label database: FDA Drug Safety Communication: codeine and tramadol in pregnant and breastfeeding women; OpenFDA codeine drug label.
Interaction severity
Rated major: the FDA issued a specific Drug Safety Communication on codeine in pregnancy because of neonatal opioid withdrawal and respiratory depression risk, and some women rapidly convert codeine to morphine, creating dangerously high levels for the baby near delivery.
This page contains affiliate links through Amazon and CJ Affiliate. As an Amazon Associate we earn from qualifying purchases. We may earn a commission if you buy through them, at no extra cost to you.
Supports bump, back and hips for a more comfortable night's sleep throughout pregnancy.
Check Price →Comprehensive pregnancy supplement with folic acid, iron and vitamin D — NHS recommended nutrients.
Check Price →Week-by-week guide to pregnancy, birth and the first weeks of parenthood.
Check Price →Who should be careful?
All pregnant women should avoid codeine. If strong pain relief is needed in pregnancy, discuss alternatives (paracetamol first, then obstetric pain management if severe) with your GP or midwife.
What if I've already taken Codeine and Pregnancy?
If you took co-codamol in early pregnancy before knowing you were pregnant, inform your midwife. The risk from early occasional use is lower than prolonged use near term. Do not take more codeine-containing products.
Managing multiple medications day to day? AutomationHomeGuide covers smart medication reminders and other home tech that helps.
Confirming a pregnancy raises questions medication alone can't answer.
Paternity Lab offers fast, confidential DNA testing with results in as little as 24 hours.
Order a DNA test at Paternity Lab →Affiliate link — we may earn a commission at no extra cost to you.
This page contains affiliate links through Amazon and CJ Affiliate. As an Amazon Associate we earn from qualifying purchases. We may earn a commission if you buy through them, at no extra cost to you.
CJ — LAWDEPOTLawDepot — legal documents made simple. Child travel consent forms, wills, power of attorney and more — fill in online, print immediately.
Create legal document at LawDepot →Curious what a DNA test can reveal beyond parentage? 247GeneticCheck covers health and ancestry testing alongside DNA verification.
Frequently Asked Questions
Can I take codeine when pregnant?
No. Codeine should be avoided in pregnancy, particularly in the third trimester. Paracetamol is the safe painkiller to use.
Is co-codamol safe in pregnancy?
Co-codamol contains codeine and should be avoided in pregnancy. The paracetamol component is safe, but the codeine component is not.
What strong painkiller can I take in pregnancy?
Paracetamol is the first option. If pain is severe and paracetamol is insufficient, discuss with your GP or obstetric team — they can provide appropriate pain management in pregnancy.
What is neonatal opioid withdrawal syndrome?
NOWS occurs in babies born to mothers who used opioids during pregnancy. The baby experiences withdrawal after birth, with symptoms including irritability, feeding difficulties, tremors, and vomiting. It requires medical management but is treatable.