Codeine Phosphate

Codeine Phosphate

[1 tablet 9 cents]

ADMINISTRATION ROUTES:

  • PO and IM

ALTERNATIVE NAMES:

  • Codeine

ICU INDICATIONS:

  1. relief of mild to moderate pain.

PRESENTATION AND ADMINISTRATION:

  • PO:
    15mg and 30mg tablets (white)
  • IM:
    50mg/1ml vials. Inject undiluted via IM route. This route of administration is rarely used
    NOT FOR IV USE

DOSAGE:

  • PO / IM:
    15-60mg 4 hourly (max 300mg per day)

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

  • Dose in renal impairment [GFR (ml/min)]
    <10: 50-100% of normal dose
    10-20: 50-100% of normal dose
    >20-50: 75-100% of normal dose
  • Dose in renal replacement therapy
    CAPD: 50-100% of normal dose
    HD: 75-100% of normal dose
    CVVHDF: dose as in normal renal function

DOSAGE IN PAEDIATRICS:

  • PO:
    0.5-1mg/kg 4 hourly

CLINICAL PHARMACOLOGY:

  • Codeine phosphate is a centrally active analgesic

CONTRAINDICATIONS:

  1. Hypersensitivity to codeine.

WARNINGS

  • Approximately 10% of Caucasian patients do not produce the enzyme required to convert codeine from its pro-drug form. These patients will derive no benefit from codeine

PRECAUTIONS

  • General:
    The respiratory depressant effects of narcotics and their capacity to depress consciousness may be markedly exaggerated in the presence of head injury, other intracranial lesions, or a pre-existing increase in intracranial pressure.
  • Laboratory Tests:
    No tests in addition to routine ICU tests are indicated
  • Drug/Laboratory Test Interactions:
    None noted

IMPORTANT DRUG INTERACTIONS FOR THE ICU

  • Codeine in combination with other narcotic analgesics, general anesthetics, phenothiazines, tranquilizers, sedative-hypnotics, or other CNS depressants (including alcohol) has additive depressant effects.

ADVERSE REACTIONS

  • Central Nervous System:
    lightheadedness, dizziness, sedation.
  • Gastrointestinal System:
    Constipation, nausea, and vomiting.

Critical Care Drug Manual

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