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.