Codeine is an opioid medication primarily prescribed to manage mild to moderately severe pain and to suppress coughing. Derived from the opium poppy, Papaver somniferum, codeine is classified as a controlled substance due to its potential for dependence and misuse. As an opioid, codeine is metabolized into morphine, which acts on the central nervous system to block pain signals and inhibit the cough reflex. The appearance of this medication varies significantly depending on whether it is a single-ingredient pill, a combination tablet, or a liquid formulation.
Physical Forms and Appearance of Codeine
Codeine is available in several forms, including tablets, capsules, and oral solutions or syrups. Single-ingredient codeine tablets are less common than combination products and are typically small and round. These tablets are most often white or off-white, though a manufacturer may use other dyes. Pure codeine sulfate is available in immediate-release strengths commonly ranging from 15 mg to 60 mg.
Codeine phosphate is also manufactured as a liquid solution or syrup, used mainly for cough suppression. While the pure drug substance is colorless or white, the final cough syrup is usually flavored and dyed. This liquid form has a thick, syrupy consistency and can range from clear to slightly colored.
Key Identification Markings
Identification of any prescription pill relies heavily on the alphanumeric imprints stamped onto the tablet or capsule. These unique codes are mandated by regulatory bodies like the FDA and serve as the definitive way to identify the drug, its strength, and the manufacturer. The imprint is more reliable than visual appearance alone, as pill colors and shapes can change between different generic manufacturers.
A single-ingredient codeine sulfate tablet might be identified by a simple three-digit code and a manufacturer’s logo. Combination products have unique codes corresponding to the specific mix of active ingredients, such as an acetaminophen and codeine tablet featuring an imprint like “2064 V 3”. If a pill lacks an imprint, it is not a legal, regulated prescription or over-the-counter medication in the United States and could be an illicit or counterfeit product. Consulting an online pill identifier tool using the exact imprint, color, and shape is the most accurate method for preliminary identification.
Codeine in Compound Medications
Most codeine prescribed is found in combination with other active ingredients, which significantly alters its physical appearance. The two most common compounds are codeine combined with acetaminophen and codeine combined with an antihistamine.
When combined with acetaminophen, the resulting tablets are usually white and round or oblong. The different strengths of codeine (7.5 mg, 15 mg, 30 mg, or 60 mg) are the primary factor distinguishing the specific marking, though the pill’s color and shape remain consistent for a given manufacturer.
Codeine is also frequently compounded with promethazine, an antihistamine, to create prescription cough syrup. This combination is a thick oral solution. While the base solution is often clear, the final product is commonly manufactured as a purple or sometimes red syrup to make it visually distinguishable. These liquid formulations are typically dispensed in brown or amber bottles to protect the ingredients from light.
Safety and Misidentification Warning
Attempting to identify medication solely by sight carries significant risk, especially with controlled substances like codeine. Counterfeit pills are a serious danger, as they can be pressed to look identical to legitimate pharmaceuticals but contain unknown and potentially lethal substances, such as fentanyl. This risk is particularly high if the medication was not acquired through a legitimate pharmacy with a valid prescription.
Never consume any medication that cannot be definitively identified through professional means, such as by a pharmacist or physician. If a pill has no imprint or if its appearance raises suspicion, it should be considered unsafe. Proper storage in a secure location and safe disposal of unused opioids are necessary steps to prevent accidental ingestion or misuse.