Codeine: Difference between revisions
(Text replacement - "qd" to "QD") |
(Text replacement - "prn" to "PRN") |
||
| Line 9: | Line 9: | ||
==Adult Dosing== | ==Adult Dosing== | ||
*Mild to moderate pain: 15-60mg PO q4-6h | *Mild to moderate pain: 15-60mg PO q4-6h PRN | ||
**Max: 360mg/day | **Max: 360mg/day | ||
**Give with food | **Give with food | ||
**Doses >60mg are rarely more effective in opioid-naive patients | **Doses >60mg are rarely more effective in opioid-naive patients | ||
*Cough: 15-30mg PO q4-6h | *Cough: 15-30mg PO q4-6h PRN | ||
**Max: 120mg/day | **Max: 120mg/day | ||
*[[Diarrhea]]: 45-270mg/day PO divided q4-6h | *[[Diarrhea]]: 45-270mg/day PO divided q4-6h PRN | ||
**Start: 30-60mg/day PO divided QD-bid, then increase by 30-60mg/day | **Start: 30-60mg/day PO divided QD-bid, then increase by 30-60mg/day PRN | ||
**Max: 60mg/dose up to 270mg/day | **Max: 60mg/dose up to 270mg/day | ||
==Pediatric Dosing== | ==Pediatric Dosing== | ||
*Pain, mild-moderate | *Pain, mild-moderate | ||
**3-6 yo: 0.5-1mg/kg PO q4-6h | **3-6 yo: 0.5-1mg/kg PO q4-6h PRN | ||
**7-12 yo: 15-30mg PO q4-6h | **7-12 yo: 15-30mg PO q4-6h PRN | ||
**13-17 yo: 15-60mg PO q4-6h | **13-17 yo: 15-60mg PO q4-6h PRN | ||
**Max: 60mg/dose up to 360mg/day | **Max: 60mg/dose up to 360mg/day | ||
*Cough | *Cough | ||
**2-5 yo: 1-1.5mg/kg/day PO divided q4-6h | **2-5 yo: 1-1.5mg/kg/day PO divided q4-6h PRN; Max: 30mg/day | ||
**6-11 yo: 1-1.5mg/kg/day PO divided q4-6h | **6-11 yo: 1-1.5mg/kg/day PO divided q4-6h PRN; Max: 60mg/day | ||
==Special Populations== | ==Special Populations== | ||
*Pregnancy risk factor: C | *Pregnancy risk factor: C | ||
Revision as of 12:14, 7 July 2017
Administration
- Type: Opioid
- Dosage Forms: Tablet: 15, 30, 60 Oral Solution: 30mg/5 mL
- Routes of Administration: Oral
- Pharmacologic Category: Analgesic, Opioid; Antitussive
Blackbox Warning
- Death related to ultra-rapid metabolism: respiratory depression and death have occurred in children who received codeine post-tonsillectomy and/or adenoidectomy and were ultra-rapid CYP2D6 metabolizers
Adult Dosing
- Mild to moderate pain: 15-60mg PO q4-6h PRN
- Max: 360mg/day
- Give with food
- Doses >60mg are rarely more effective in opioid-naive patients
- Cough: 15-30mg PO q4-6h PRN
- Max: 120mg/day
- Diarrhea: 45-270mg/day PO divided q4-6h PRN
- Start: 30-60mg/day PO divided QD-bid, then increase by 30-60mg/day PRN
- Max: 60mg/dose up to 270mg/day
Pediatric Dosing
- Pain, mild-moderate
- 3-6 yo: 0.5-1mg/kg PO q4-6h PRN
- 7-12 yo: 15-30mg PO q4-6h PRN
- 13-17 yo: 15-60mg PO q4-6h PRN
- Max: 60mg/dose up to 360mg/day
- Cough
- 2-5 yo: 1-1.5mg/kg/day PO divided q4-6h PRN; Max: 30mg/day
- 6-11 yo: 1-1.5mg/kg/day PO divided q4-6h PRN; Max: 60mg/day
Special Populations
- Pregnancy risk factor: C
Renal Dosing
- CrCl 10-50: decrease dose 25%; CrCl <10: decrease dose 50%; HD/PD: no supplement
Contraindications
- hypersensitivity to codeine
- respiratory depression
- paralytic ileus
- post-tonsillectomy or adenoidectomy (peds)
Adverse Reactions
Serious
- respiratory depression
- CNS depression
- hypotension
- bradycardia
- syncope
- anaphylactoid reaction
Common
- lightheadedness
- dizziness
- sedation
- nausea/vomiting
Pharmacology
- Half-life: 2.5-4 hours
- Metabolism: Liver
- Excretion: Urine
Mechanism of Action
- Opioid agonist
See Also
References
- Micromedex
- UptoDate