Codeine oral

Therapeutic action

Opioid analgesic.

Indications

Use for short term treatment because of the risk of dependence and tolerance.

Due to the numerous and potentially severe adverse effects of codeine, patients should be kept under close surveillance.

• Moderate pain, alone or in combination with a non-opioid analgesic.

Forms and strengths

• 30 mg codeine phosphate tablet.

Dose

• Child over 12 years and adult: 30 to 60 mg every 4 to 6 hours, maximum 240 mg daily.

Duration

According to clinical evolution; as short as possible.

Contra-indications, adverse effects, precautions

• Do not administer to patients with acute respiratory depression or asthma attack.
• May cause constipation, nausea, vomiting, drowsiness, and dizziness.
• Rarely, may cause respiratory depression, allergic reactions, dependence, and withdrawal syndrome.
• Do not combine with other agonist opioids such as morphine because of the increased risk of respiratory depression.
• Do not combine with agonist-antagonist opioids such as buprenorphine, nalbuphine, or pentazocine because of competitive action.
• Reduce dosage in patients with renal or hepatic impairment and in elderly patients.
• Pregnancy: no contra-indication, but the newborn may develop withdrawal symptoms, respiratory depression, and drowsiness in the event of prolonged administration of large doses at the end of the 3rd trimester. In this event, closely monitor the newborn infant.
• Breast-feeding: use with caution, for a short period of 2 to 3 days, at the lowest effective dose. Monitor the mother and the infant and stop treatment if excessive drowsiness occurs.