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Postoperative pain management in children Acute or severe bronchial asthma in an unmonitored setting or in the absence of resuscitative equipment. Opioids can cause sleep-related breathing disorders including central sleep apnea CSA and sleep-related hypoxemia; opioid use increases risk of CSA in a dose-dependent fashion; in patients who present with CSA, consider decreasing opioid dosage using best practices for opioid taper.
Therapy may cause severe hypotension including orthostatic hypotension and syncope in ambulatory patients; there is increased risk in patients whose ability to maintain blood pressure has already been compromised by Uses of codeine reduced blood volume or concurrent administration of certain CNS depressant drugs e. In patients who may be susceptible to intracranial effects of CO2 retention e. Contraindicated in patients with known or suspected gastrointestinal obstruction, including paralytic ileus; may cause spasm of sphincter of Oddi; opioids may cause increases in serum amylase; monitor patients with biliary tract disease, including acute pancreatitis, for worsening symptoms.
Therapy may increase frequency of seizures in patients with seizure disorders, and may increase risk of seizures occurring in other clinical settings associated with seizures; monitor patients with history of seizure disorders for worsened seizure control during therapy. Warn patients not to drive or operate dangerous machinery unless they are tolerant to effects of drug and know how they will react to medication.
While serious, life-threatening, or fatal respiratory depression can occur at any time during therapy, risk is greatest during initiation of therapy or following dosage increase; monitor patients closely for respiratory depression, especially within first 24 to 72 hr of initiating therapy with and following dosage increases; accidental ingestion of even one dose, especially by children, can result in respiratory depression and death due to overdose of codeine. Deaths have occurred in nursing infants exposed to high levels of morphine in breast milk because mothers were ultra-rapid metabolizers of codeine.
Uses of codeine not abruptly discontinue buprenorphine in a patient physically dependent on opioids; when discontinuing therapy, in a physically dependent patient, gradually taper the dosage; rapid tapering in a patient physically dependent on opioids may lead to a withdrawal syndrome and return of pain. If an opioid analgesic is initiated in a patient already taking a benzodiazepine, a muscle relaxant, or other CNS depressant, prescribe a lower initial dose of the opioid analgesic, and titrate based on clinical response; follow patients closely for s and symptoms of respiratory depression and sedation.
Use in patients with acute or severe Uses of codeine asthma in an unmonitored setting or in absence of resuscitative equipment is contraindicated; patients with ificant chronic obstructive pulmonary disease or cor pulmonale, and with substantially decreased respiratory reserve, hypoxia, hypercapnia, or pre-existing respiratory depression are at increased risk of decreased respiratory drive including apnea, even at recommended dosages.
Life-threatening respiratory depression is more likely to occur in elderly, cachectic, or debilitated patients because they may have altered pharmacokinetics or altered clearance compared to younger, healthier patients; Uses of codeine closely. Cases of adrenal insufficiency reported with opioid use, more often following greater than one month of use; symptoms may include nausea, vomiting, anorexia, fatigue, weakness, dizziness, and low blood pressure; if adrenal insufficiency is diagnosed, treat with physiologic replacement doses of corticosteroids; wean patient off of opioid to allow adrenal function to recover and continue corticosteroid treatment until adrenal function recovers; other opioids may be tried as some cases reported use of a different opioid without recurrence of adrenal insufficiency.
Chronic use of opioids may cause reduced fertility in females and males of Uses of codeine potential. It is not known whether these effects on fertility are reversible. Use caution when selecting dosage for an elderly patient, usually starting at low end of dosing range, reflecting greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy; because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and may be useful to monitor renal function.
Codeine pharmacokinetics may be altered in patients with renal failure; clearance may be decreased and metabolites may accumulate much higher plasma levels in patients with renal failure as compared to patients with normal renal function; start with a lower than normal dosage or with longer dosing intervals and titrate slowly while monitoring for s of respiratory depression, sedation, and hypotension.
When prescribing codeine for adolescents, healthcare providers should choose lowest effective dose for shortest period of time and inform patients and caregivers about risks and s of morphine overdose. At least one death reported in a nursing infant exposed to high levels of morphine in breast milk because mother was an ultra-rapid metabolizer of codeine; breastfeeding is not recommended during treatment with codeine sulfate oral solution.
Risk of life-threatening side effects in nursing infants, especially if mother Uses of codeine an ultra-rapid metabolizer Uses of codeine codeine. Pregnancy: Prolonged use of opioid analgesics during pregnancy for medical or nonmedical purposes can result in physical dependence in the neonate and neonatal opioid withdrawal syndrome shortly after birth; observe newborns for symptoms of neonatal opioid withdrawal syndrome and manage accordingly; opioids cross placenta and may produce respiratory depression and psycho-physiologic effects in neonates; an opioid antagonist, such as naloxone, must be available for reversal of opioid-induced respiratory depression in the neonate; codeine sulfate is not recommended for use in pregnant women during or immediately prior to labor, when other analgesic techniques are more appropriate; opioid analgesics can prolong labor through actions which temporarily reduce strength, duration, and frequency of uterine contractions.
Lactation: Codeine is secreted into human milk; in women with normal codeine metabolism normal CYP2D6 activityamount of codeine secreted into human milk is low and dose-dependent; some women are ultra-rapid metabolizers of codeine; these women achieve higher-than-expected serum levels of codeine's active metabolite, morphine, leading to higher-than-expected levels of morphine in breast milk and potentially dangerously high serum morphine levels in their breastfed infants that can potentially lead to serious adverse reactions, including death, in nursing infants; there is no information on effects of codeine on milk production.
Adding plans allows you to compare formulary status to other Uses of codeine in the same class. To view formulary information first create a list of plans. Your list will be saved and can be edited at any time. The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
By clicking send, you acknowledge that you have permission to the recipient with this information. For You. Decision Point. Log In. Uses of codeine It's Free! Register Log In. No. If you log out, you will be required to username and password the next time you visit. Log out Cancel. Brand and Other Names:. Share Print Feedback Close. Sections codeine. ificant - Monitor Closely. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Patient Handout. Print without Office Info.
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Formulary Formulary Patient Discounts. Create Your List of Plans. View explanations for tiers and restrictions. Tier Description 1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs. Most commonly, these are "preferred" on formulary brand drugs. Most commonly, these are "non-preferred" brand drugs. Most commonly, these are "non-preferred" brand drugs or specialty prescription products. This Uses of codeine requires that specific clinical criteria be met prior to the approval of the prescription.
QL Quantity Limits Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered. ST Step Therapy Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
OR Other Restrictions Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription. Non-Medicare Plans Medicare Plans. From: To:. Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature. What would you like to print?
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This drug is available at a middle level co-pay. This drug is available at a higher level co-pay. Prior Authorization Drugs that require prior authorization.Uses of codeine
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