What is Codeine Phosphate? How is it used?
Codeine Phosphate can be prescribed to relieve mild to moderately severe pain. Codeine Phosphate can be taken alone or in combination with other medications.
Codeine phosphate is a drug that belongs to the Analgesics (Opioids) class.
It is unknown if Codeine Phosphate can be used safely and effectively in children.
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What side effects can Codeine Phosphate cause?
Codeine Phosphate may cause serious side effects including:
Loud breathing
sighing,
Breathing shallow
Breathing that stops while you sleep
Slow heart rate
A weak pulse
lightheadedness,
confusion,
Unusual thoughts and behavior
Feelings of extreme happiness and sadness
convulsions (seizures),
Problems with urination
nausea,
vomiting,
Appetite loss
Dizziness and
Worsening fatigue or weakness
If you experience any of these symptoms, get medical attention immediately.
Codeine Phosphate’s most frequent side effects are:
Feeling dizzy or drowsy
constipation,
nausea,
You can also get vomiting.
stomach pain
If you experience any side effects that are bothersome or persistent, tell your doctor.
These are just a few of the side effects that Codeine Phosphate can cause. Ask your pharmacist or doctor for more information.
Codeine, an alkaloid derived from opium and morphine by methylation, is found as white crystals. Codeine is slow to bloom in dry air, and it can be affected by light. The chemical name of codeine phosphate is 7,8-Didehydro-4,5alpha-epoxy-3-methoxy-17-methylmorphinan-6alpha-ol phosphate (1:1)(salt) hemihydrate and has the empirical formula of C18H21NO3*H3PO4*1/2H20. It has a molecular mass of 406.4.
Each soluble tablet contains 30mg (0.074mmol) and 60mg (0.15mmol) codeine phosphate. These tablets also contain sucrose and lactose.
Soluble codeine phosphate tablets are easily soluble in water. These tablets are used to prepare parenteral solutions. These tablets are not sterilizable. Codeine phosphate can be used as an analgesic.
INDICATIONS
Codeine phosphate can be used to relieve mild to moderate pain.
DOSAGE & ADMINISTRATION
Analgesia: The dose should be adjusted based on the intensity of the pain and the patient’s response.
Adults: 15-60 mg every 4-6 hours (usual adult dose is 30 mg).
Children 1 year of age and older – 0.5 mg/kg b.d. Weight or 15 mg/m2 b.d. Every 4 to 6 hours, surface.
Subcutaneously or intramuscularly, luble tablets of codeine phosphate can be administered.
Solution for injection should first be prepared using sterile water. Then filter through a 0.22 membrane filtrate.
Notify us if the solution is discolored more than a little or contains precipitates.
SIDE EFFECTS
Lightheadedness, dizziness and nausea are the most common adverse reactions. These adverse reactions are more common in patients who are ambulatory than those who are not. Some of these effects can be mitigated by lying down.
Other side effects include euphoria and dysphoria as well as constipation and pruritus.
Drug Abuse and Dependence
Controlled Substance Codeine phosphate (Schedule II Narcotic) is a controlled substance.
Dependence
Codeine is less powerful than morphine in this regard, but it can cause drug dependence. Therefore, it could be misused. It is common for patients to experience mild withdrawal symptoms and tolerance after being given 60 mg of codeine every six hours for two months. The development of a dependent state can be seen in an increase in tolerance to the analgesic effects and the appearance or manipulation of purposive phenomena (complaints/pleas, demands, or other actions) just before the next scheduled dose. In order to treat a patient suffering from withdrawal, it is important that they are admitted to a hospital. It is usually not necessary to administer a tranquilizer to reduce anxiety. Instead, supportive care should be provided. Sometimes, severe withdrawal symptoms may need to be treated with a substitute narcotic.
DRUGS INTERACTIONS
Codeine can be used in combination with narcotic analgesics or general anesthetics. It may also interact with tranquilizers, CNS depressants, sedative-hypnotics, and phenothiazines. If s.c. combination therapy are considered, it is important to reduce the dosage of either one or both agents.
PRECAUTIONS
General
Head Injury and Higher Intracranial Pressure Patients with head injuries may also experience adverse reactions to narcotics that can obscure the course of treatment.
Acute Abdominal Conditions: Codeine and other narcotics can mask the diagnosis or delay in treatment for patients suffering from acute abdominal conditions.
Special-Risk Patients Codeine should not be administered to patients with severe impairments of their liver or kidney function, hypothyroidism or Addison’s syndrome, prostatic hypertrophy, or urethral stricture.
Patients with Kidney and Liver Dysfunction may experience a long-lasting cumulative effect from codeine phosphate.
Information for the patient
Codeine can cause impairment of mental and/or bodily abilities that are required to perform potentially dangerous tasks such as driving a vehicle or operating machinery. Codeine can be combined with narcotic analgesics such as phenothiazines and sedative-hypnotics like alcohol to cause depressant effects.
Pregnancy
Codeine phosphate has not been used in animal reproduction studies during pregnancy Category C. It is not known if codeine phosphate can cause harm to the fetus or affect reproductive capacity. Based on the history of codeine phosphate use during pregnancy at all stages, it is unlikely that there will be any fetal abnormalities. Only give codeine phosphate to pregnant women if it is absolutely necessary.
Delivery and labor
Codeine phosphate may prolong labor. It can pass the placental barrier, and may cause depression in newborns. In severe depression, naloxone may need to be administered for rescue.
Nursing mothers
Codeine is found in breast milk. When codeine is given to a nursing mother, it should be used with caution.
Overdosage and Contraindications
DO NOT OVERDOSE
Signs and Symptoms
Codeine is converted to morphine by the body. Its effects are very similar to those of morphine or other opiate painkillers. Common signs of overdose include respiratory depression, sedation, and miosis. Other symptoms include nausea and vomiting, skeletal muscle flaccidity (bradycardia), hypotension, cool, clammy, and bradycardia. Children have experienced apnea that has led to death from as low as 5 mg/kg. Opioid overdose may occur in noncardiac pulmonary embolism. Monitoring of the heart filling pressure can be useful.
Treatment
Your Certified Regional Control Center is a great resource for current information regarding the treatment of overdose. The beginning of Physicians GenRx lists the telephone numbers of certified poison control centres. When managing overdosage, you should consider multiple drug overdoses, interactions among drugs, as well as unusual drug kinetics.
Naloxone can block most of the effects of codeine. Naloxone can cause vomiting so be sure to protect your airways. Naloxone’s duration of action is shorter than that of codeine, so repeated doses may be necessary. A withdrawal syndrome can occur in patients who have used opioids for a long time. Naloxone may help to prevent this from happening. These symptoms include yawning and tearing, restlessness or sweating, dilated pupils (piloerection), vomiting, diarrhea, and abdominal pains. The effects of naloxone usually dissipate quickly and this syndrome disappears.
Assist ventilation and perfusion, and protect the patient’s airway. Monitor and maintain the patient’s vital signs, blood gasses, and serum electrolytes within acceptable limits. Activated charcoal may help to reduce drug absorption from the gastrointestinal tract. This activated charcoal is often more effective than lavage or emesis. Some drugs may be eliminated faster if they are given repeated doses of charcoal. Gastric emptying and charcoal can be used to protect the patient’s airways.
Overdoses of codeine phosphate can be prevented by hemodialysis, forced diuresis, and charcoal hemoperfusion.
CONTRAINDICATIONS
Hypersensitivity to codeine
CLINICAL PHARMACOLOGY
Codeine phosphate can be used as a centrally acting analgesic. Codeine phosphate can be administered intravenously at 120 mg. It produces an analgesic effect that is comparable to 10 mg of morphine. Other effects include respiratory depression, depression of the cough centre, release of antidiuretic hormonal; activation of vomiting center; pupillary constrictions; a decrease of gastric, pancreatic and biliary secretion; reduced intestinal motility; an amplitude in ureteral contractions; and an increase in pressure.
Within 10-30 minutes, analgesia is experienced following intramuscular and subcutaneous injections. It lasts between 4 and 6 hours.
The majority of codeine taken in daily doses is eliminated within 24 hours. 5% to 15% of the codeine remains unchanged and the rest as a result of glucuronide codeine conjugates and its metabolites.