Codeine Phosphate
Codeine is an opioid analgesic. It is much less potent as an analgesic than morphine and has relatively mild sedative effects. Codeine or its salts, especially the phosphate, are given orally in the form of linctus for the relief of cough, and as tablets for the relief of mild to moderate pain, often with a non-opioid analgesic such as paracetamol.
Pronunciation
Codeine phosphate 30mg
| Generic Name 藥名 | HA Code 藥物代碼 | Classification藥物分類 |
|---|---|---|
| Codeine phosphate 30 mg tablet | COED01 | DD |
Mechanism of Action
Equivalent doses of opioid analgesics
| Analgesic/Route | Dose |
|---|---|
| Codeine: PO | 100 mg |
| Diamorphine: IM, IV, SC | 3 mg |
| Dihydrocodeine: PO | 100 mg |
| Morphine: PO | 10 mg |
| Morphine: IM, IV, SC | 5 mg |
| Oxycodone: PO | 6.6 mg |
| Tramadol: PO | 100 mg |
| Route of Administration | IV | ||
|---|---|---|---|
| PO (tablet form) | |||
| PO (suspension) |
Dosage
Mild to moderate pain:
Oral: 30-60 mg every 4 hours, max 240 mg/day.
For non-productive cough:
Oral: 15 to 50mg three or four times daily.
Doses in children
The use of codeine is restricted to the short-term treatment of acute, moderate pain in children over 12 years of age who do not respond to other analgesics such as paracetamol or ibuprofen.
The recommended oral dose:
- 30 to 60 mg (0.5 to 1 mg/kg) of codeine phosphate given every 6 hours when necessary, max of 240 mg daily.
- The duration of treatment should not exceed 3 days.
Side Effects
As for Opioid Analgesic in general
The commonest adverse effects are nausea, vomiting, constipation, drowsiness and confusion.
Large doses of opioids produce respiratory depression and hypotension, with circulatory failure and deepening coma. Death may occur from respiratory failure.
Treatment of Adverse Effects
1. Constipation can be treated with laxatives such as senna tables and lactulose. 2. Nausea and vomiting can be alleviated by metoclopramide. 3. Intensive supportive therapy may be required to correct respiratory failure and shock. Naloxone is used for rapid reversal of the severe respiratory depression and coma.
Euphoria, nausea and vomiting, respiratory depression, constipation and cough suppression
Pharmacokinetics
| Oral bioavailability | Codeine and its salts are absorbed from the gastrointestinal tract. |
|---|---|
| Onset of action | |
| Excreation | Codeine and its metabolites are excreted almost entirely by the kidney. |
| Elimination half-life | The plasma half-life has been reported to be between 3 and 4 hours after an oral or intramuscular dose. |
Drug Management
Efficiency
Pain control
Safety
mental status, blood pressure, respiratory drive, and misuse / overuse.
Caution
Acute abdominal, gallstone, cardiac arrhythmias Tolerance and dependence
Contraindication
Acute ulcerative colitis, antibacterial associated colitis
FAQ
How should I take the tablet?
Follow the doctor's prescription, Take with or without food Take the medication with plenty of water Can be crushed Do not crushed modified-released formulation tablet
What should I avoid while taking?
Avoid abrupt withdrawal
What happen if I overdose?
Emergency situation, called 999 immediately Antidote: Naloxone
What happen if I miss a dose?
Take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.
