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Codeine-containing medicines. Table of contents Overview Key facts All documents. Current status. Restrictions on use of codeine for pain relief in children — CMDh endorses PRAC recommendation The Coordination Group for Mutual Recognition and Decentralised Procedures — Human CMDh has endorsed by consensus a series of risk-minimisation measures to address safety concerns with codeine-containing medicines when used for the management of pain in children.
The CMDh agreed with the PRAC 's conclusions and endorsed the following recommendations: Codeine-containing medicines should only be used to treat acute short-lived moderate pain in children above 12 years of age, and only if it cannot be relieved by other painkillers such as paracetamol or ibuprofen, because of the risk of respiratory depression associated with codeine use.
Codeine should not be used at all in children aged below 18 years who undergo surgery for the removal of the tonsils or adenoids to treat obstructive sleep apnoea, as these patients are more susceptible to respiratory problems. The product information of these medicines should carry a warning that children with conditions associated with breathing problems should not use codeine. Expand section Collapse section. Because of a risk of breathing problems, the use of codeine medicines for pain relief in children has been restricted: these medicines are now only to be used to treat acute short-lived moderate pain in children above 12 years of age, and only if it cannot be relieved by other painkillers such as paracetamol or ibuprofen.
All children aged below 18 years who undergo surgery for the removal of the tonsils or adenoids to treat obstructive sleep apnoea frequent interruption of breathing during sleep should not be given codeine as they are more at risk of breathing problems.
Mothers who are breastfeeding should not take codeine because codeine can pass to the baby through breast milk. Patients who are known to be 'ultra-rapid metabolisers', which means that they are more at risk of serious side effects with codeine, should not use codeine as pain relief. Parents and caregivers who notice any of the following symptoms in a patient given codeine should stop giving the medicine and seek medical attention immediately: slow or shallow breathing, confusion, sleepiness, small pupils, feeling or being sick, constipation and lack of appetite.
If you or your child are being treated with codeine and have any questions or concerns about your treatment, speak to your doctor or pharmacist. Codeine is now only indicated in patients older than 12 years of age for the treatment of acute moderate pain that cannot be relieved by other analgesics such as paracetamol or ibuprofen alone.
Codeine should be used at the lowest effective dose for the shortest period of time. Codeine is not recommended for use in children in whom respiratory function might be compromised as this may worsen the symptoms of morphine toxicity.
Codeine is an Opiate and a Narcotic. Other Opiates include Oxycodone , Heroin , and Morphine. Codeine use often starts out innocently, with a prescription for a Codeine-based cough syrup. Because Codeine is less regulated than some Opiates considered to be more dangerous such as Morphine and OxyContin , getting and abusing it is relatively easy.
This is despite the fact that Codeine is very similar chemically to drugs such as Morphine and Hydrocodone. Though less potent, Codeine provides effects similar to Morphine. As an Opiate, Codeine runs a high risk of its users developing a tolerance and, eventually, a dependence on it. Although many people begin using Codeine to relieve a legitimate condition, it is frequently abused as tolerance develops. Many Codeine users begin to turn to the drug to cope with all of their physical pain and, eventually, their emotional pain as well.
Although some people think the drug seems harmless, at high enough doses Codeine use can lead to respiratory failure, coma, and even death. Make a Call An addiction to Codeine may develop from continued abuse of the drug in its cough medicine or pill forms.
Codeine can lull its users into a false sense of security, as many people do not consider it to be as powerful or as addictive as its Opiate family members.
They try to reach a better high by mixing it with other substances, including alcohol. Because Codeine and alcohol are both CNS Depressants , combining them can lead to dangerous levels of depression in the brain and respiratory failure. Galloway, NJ. View Center. Nashville, TN. For some people, Codeine is only a piece of a larger web of addictions. Sometimes, it is the gateway drug into addiction to other substances, especially other Opiates like Oxycodone or Morphine.
No matter what drugs you use, there is a treatment solution available. It is also called Lean, Syrup, and Sizzurp. Tell your doctor or pharmacist if you're taking any other medicines, including herbal medicines, vitamins or supplements. It works in the central nervous system and the brain to block pain signals to the rest of the body. It also reduces the anxiety and stress caused by pain. When codeine blocks the pain, there are other unwanted effects - for example slow or shallow breathing.
It also slows down digestion, which is why codeine can cause constipation. A codeine injection into a vein gives the quickest pain relief. It works almost straight away.
Codeine tablets, liquid and cough syrup all work in 30 to 60 minutes, but they wear off after a few hours. Yes, codeine is addictive. For this reason, your dose will be reviewed to make sure you are only taking the amount you need to control your pain, or diarrhoea.
Your treatment plan may include details of how and when you will stop taking codeine. If you need to take it for a long time your body can become tolerant to it. That means you need higher doses to control your pain over time. Some people can become more sensitive to pain hyperalgesia. If this happens, your doctor will reduce your dose gradually to help these symptoms. Speak to your doctor if you are worried about tolerance, hyperalgesia or becoming addicted.
If you're addicted to codeine, you may want to take it more often or feel agitated if you delay taking a dose for any reason. And if you stop taking codeine suddenly you may suffer from withdrawal symptoms. Drinking alcohol while you're on codeine may make you feel more sleepy or increase the risk of serious side effects.
It's best to stop drinking alcohol during the first few days of treatment until you see how codeine affects you. If you feel sleepy with codeine, stop drinking alcohol while you're taking it. Children aged 12 to 18 years can take codeine for pain or diarrhoea - but only if other medicines haven't worked. Use the lowest dose that works for no more than 3 days. If they still have symptoms after 3 days see a doctor. Codeine shouldn't be given to children aged 12 to 18 years if they have breathing problems or if they have had their tonsils or adenoids removed because of obstructive sleep apnoea.
If you're taking codeine for a short time and at normal doses, there's no firm evidence that it can reduce fertility. However if you've been taking it for a long time and you're concerned about your fertility, or you're trying to get pregnant, speak to a pharmacist or your doctor. The type of painkiller that's best depends on what type of pain you have.
If codeine doesn't get rid of your pain or becomes less effective, talk to your doctor. Codeine is a controlled medicine. This means there are extra rules on how it's prescribed and dispensed to make sure it's not given to the wrong person or misused. However, this doesn't affect you as a patient. The rules only apply to the pharmacy that dispenses it. When you first take codeine, you'll probably feel sleepy for a few days.
But the sleepiness will wear off as your body gets used to the medicine. You might notice you're less alert. In this case, you might choose to have less than perfect pain relief as a trade-off. Do not drive a car or ride a bike if codeine makes you sleepy during the daytime, gives you blurred vision or makes you feel dizzy, clumsy or unable to concentrate or make decisions.
This may be more likely when you first start taking codeine but could happen at any time - for example when starting another medicine. It's an offence to drive a car if your ability to drive safely is affected. It's your responsibility to decide if it's safe to drive. If you're in any doubt, do not drive. Even if your ability to drive is not affected, the police have the right to request a saliva sample to check how much codeine is in your body.
UK has more information on the law on drugs and driving. Talk to your doctor or pharmacist if you're unsure whether it's safe for you to drive while taking codeine. Codeine doesn't affect any type of contraception, including the combined pill or emergency contraception. But, if you are taking codeine because you have severe diarrhoea for more than 24 hours, your contraceptive pills may not protect you from pregnancy.
Look on the pill packet to find out what to do. If you take recreational drugs, such as cannabis, cocaine and heroin while you're taking codeine, you're more likely to get the serious side effects of codeine including breathing difficulties, heart problems, seizures and even go into a coma. Some recreational drugs, such as cannabis, will also increase codeine side effects such as sleepiness and dizziness. Taking heroin while you're on prescribed codeine is especially dangerous.
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