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Administration
May be taken with or without food.
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Contraindications
Acute respiratory depression, comatose states, liver failure, acute or severe bronchial asthma, GI obstruction, paralytic ileus, abdominal distension, acute alcoholism, head injuries, increased intracranial pressure, diarrhoea caused by pseudomembranous colitis or poisoning. CYPD26 ultrarapid metabolisers. Hepatic impairment (IM inj). Children <12 years old; <18 years of age who undergo tonsillectomy and/or adenoidectomy; 12-18 years old who have other risk factors for respiratory depression; <18 years old (when used in the management of cough). Lactation. Concomitant or within 14 days of MAOI use.
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Special Precautions
Patient with hypotension, hypothyroidism, prostatic hypertrophy, urethral stricture, adrenocortical insufficiency, acute abdominal conditions, biliary tract dysfunction (e.g. acute pancreatitis), inflammatory or obstructive bowel disorders, shock, convulsive disorders, myasthenia gravis, phaeochromocytoma, mental health conditions, toxic psychosis, history of drug abuse or acute alcoholism. Morbidly obese patients. CYP2D6 extensive, intermediate, and poor metabolisers. Renal and hepatic impairment. Children and elderly. Pregnancy. Patient Counselling This drug may cause drowsiness or visual disturbances (e.g. blurred or double vision), if affected, do not drive or operate machinery. Monitoring Parameters Monitor pain relief, blood pressure, heart rate, respiratory and mental status; development of addiction, abuse or misuse.
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Adverse Reactions
Significant: CNS depression, hypotension, constipation.
Blood and lymphatic system disorders: Lymphadenopathy, splenomegaly.
Cardiac disorders: Tachycardia, bradycardia, palpitations.
Endocrine disorders: Hyperglycaemia.
Eye disorders: Miosis, blurred or double vision.
Gastrointestinal disorders: Nausea, vomiting, dry mouth, pancreatitis, stomach cramps.
General disorders and administration site conditions: Fever, malaise, tiredness.
Hepatobiliary disorders: Biliary spasm.
Immune system disorders: Maculopapular rash.
Metabolism and nutrition disorders: Anorexia.
Musculoskeletal and connective tissue disorders: Muscular rigidity, uncontrolled muscle movements.
Nervous system disorders: Dizziness, headache, vertigo, raised intracranial pressure, convulsions.
Psychiatric disorders: Confusion, restlessness, mood disorder, mental depression, hallucinations, nightmares.
Renal and urinary disorders: Urinary retention, difficulty in micturition, dysuria.
Reproductive system and breast disorders: Sexual dysfunction, decreased libido.
Respiratory, thoracic and mediastinal disorders: Dyspnoea.
Skin and subcutaneous tissue disorders: Rash, pruritus, urticaria, sweating.
Vascular disorders: Hypotension.
Potentially Fatal: Respiratory depression. |
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C
D if prolonged use/high doses at term.
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Drug Interactions
Increased risk of CNS or respiratory depression with benzodiazepines (e.g. anxiolytics, sedatives), anaesthetics, antihistamines, and sodium oxybate. Increased risk of severe constipation with anticholinergics and antidiarrhoeals. Quinidine may impair codeine metabolism. Cimetidine may increase plasma concentration of codeine. Delays the absorption of mexiletine. Antagonises the effect of domperidone, metoclopramide, cisapride.
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CIMS Class
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ATC Classification
R05DA04 - codeine ; Belongs to the class of opium alkaloids and derivatives. Used as cough suppressant.
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