CODEINE oral

Prescription under medical supervision

Therapeutic action

– Opioid analgesic

Indications

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

Forms and strengths

– 30 mg codeine phosphate tablet

Dosage

– 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, dizziness;
• rarely: respiratory depression, allergic reactions, dependence, withdrawal syndrome.
– Do not combine with:
• other agonist opioids such as morphine (increased risk of respiratory depression);
• agonist-antagonist opioids such as buprenorphine, nalbuphine, pentazocine (competitive action).
– Reduce dosage in patients with renal or hepatic impairment and in elderly patients.
– Management of respiratory depression includes assisted ventilation and/or administration of naloxone.
– Pregnancy: no contra-indication. The newborn infant 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 (2-3 days), at the lowest effective dose. Monitor the mother and the infant: in the event of excessive drowsiness, stop treatment.

Remarks

– Administer an appropriate laxative (e.g. lactulose) if analgesic treatment continues more than 48 hours.
– In some countries, codeine is on the list of narcotics: follow national regulations.
  Storage: below 25 °C -