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Codeine (Codeine Sulfate) - Summary

 
 



CODEINE SUMMARY

Chemically, codeine is Morphinan-6-ol,7,8-didehydro-4,5-epoxy-3-methoxy-17-methyl-(5alpha,6alpha)-, sulfate (2:1) (salt), trihydrate.

Codeine sulfate is an opioid analgesic indicated for the relief of mild to moderately severe pain where the use of an opioid analgesic is appropriate.


See all Codeine indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Codeine

PRAC Reviewing Safety of Codeine for Cough/Colds in Kids
Source: Medscape Medical News Headlines [2014.04.11]
The EMA committee will review available evidence on the benefit-risk balance of codeine-containing medicines when used for cough and cold in children.
News Alerts

Getting in Front of Back Pain
Source: Yahoo Health News [2014.04.12]
SATURDAY, April 12, 2014 (HealthDay News) -- Even though back pain affects nearly 10 million Americans a year, there's a lot you can do to avoid the problem, an expert says. It begins with healthy habits, including not smoking along with maintaini...

14th Annual Strategic Project and Portfolio Management for Pharma, 26-28 January 2015, Spain
Source: Conferences News From Medical News Today [2014.04.11]
14th Annual Strategic Project and Portfolio Management for Pharma, 26-28 January 2015, SpainThe 14th Annual Conference on Strategic Project & Portfolio Management for Pharma will look at how...

Scripps Florida Scientists win grant to study how exposure to prescription pain medication in the womb affects developing brain
Source: Pregnancy / Obstetrics News From Medical News Today [2014.04.11]
Scientists from the Florida campus of The Scripps Research Institute (TSRI) have been awarded a $472,500 Cutting Edge Basic Research Award (CEBRA) by the National Institute on Drug Abuse (NIDA) of...

A Young Woman With Unilateral Eye Pain and Erythema
Source: Medscape Ophthalmology Headlines [2014.04.10]
A 30-year-old woman presents with right eye pain, air and light sensitivity, and redness. What is your differential diagnosis, and what would you do next?
Medscape Ophthalmology

more news >>

Published Studies Related to Codeine

A randomized controlled trial comparing acetaminophen, acetaminophen and ibuprofen, and acetaminophen and codeine for postoperative pain relief after Mohs surgery and cutaneous reconstruction. [2011.07]
BACKGROUND: There are no population-based data comparing analgesics after Mohs micrographic surgery (MMS) and reconstruction. OBJECTIVE To compare the efficacy in pain management of three analgesic combinations... CONCLUSIONS: The combination of Ac+Ib is superior to Ac alone or Ac+Co in controlling postoperative pain after MMS and cutaneous reconstruction. (c) 2011 by the American Society for Dermatologic Surgery, Inc.

Analgesia with paracetamol/tramadol vs. paracetamol/codeine in one day-surgery: a randomized open study. [2011.02]
OBJECTIVES: The analgesic efficacy of two fixed combinations of tramadol/paracetamol (TP 37.5/325 mg) and codeine/paracetamol (CP 30/500 mg) was compared in 122 patients undergoing one-day surgical procedures (hallux valgus, haemorrhoidectomy, varicectomy and inguinal hernia repair), randomly treated with TP 37.5/325 mg or CP 30/500 mg one tablet after surgery ended, followed by one tablet four times daily for 48 hours... CONCLUSIONS: We conclude that a fixed association of tramadol/paracetamol is a valuable and safe tool for pain management in day hospital surgery, especially whenever any effort is done to reduce the time for hospitalization.

Influence of codeine on lobeline-induced respiratory reflexes and sensations and on ventilation with exercise in healthy subjects. [2011.01.31]
In 15 healthy subjects, the effect of 60 mg oral codeine and placebo was examined on intravenously injected lobeline-elicited respiratory reflexes and sensations. Its influence was also studied on ventilation and appearance of distressful respiratory sensations with modest but incremental exercise.It also suggests that codeine decreased these receptors' known contribution to respiratory augmentation and motor inhibition during exercise, which was seen as a delay in the onset of, and a decrease in the magnitude of respiratory discomfort during treadmill walking and an increase in the duration walked by more than half the subjects.

The effects of methylnaltrexone alone and in combination with acutely administered codeine on gastrointestinal and colonic transit in health. [2010.10]
BACKGROUND: The short-term effects of methylnaltrexone (MNTX), a peripherally acting mu-opioid receptor antagonist, on gastrointestinal and colonic transit remain unclear. AIM: To compare the effects of placebo, codeine, subcutaneous (s.c.) MNTX and codeine with s.c. MNTX on gastrointestinal and colonic transit of solids in healthy humans... CONCLUSION: Methylnaltrexone does not alter gastrointestinal or colonic transit and does not reverse acute codeine-associated delayed gut transit in health.

Differential effect of codeine on thermal nociceptive sensitivity in sleepy versus nonsleepy healthy subjects. [2010.06]
Basal sleepiness-alertness modulates drug effects...

more studies >>

Clinical Trials Related to Codeine

A Comparison of Postoperative Tramadol Versus Acetaminophen With Codeine in Children Undergoing Tonsillectomy [Recruiting]
Tonsillectomy is the most common pediatric surgical procedure performed in the US. The postoperative period can be particularly painful. Codeine (usually in mixed formulation with acetaminophen) is the most commonly prescribed opioid in the US. However, evolving data questions its ability to provide optimal pain relief, while avoiding side effects, especially in the postoperative setting. Tramadol may be a better option for children in the postoperative setting due to its well-documented analgesic properties, low potential for side effects, and excellent safety profile. Seventy-two children scheduled to undergo tonsillectomy (with or without adenoidectomy) at Children's will be invited to participate in a randomized, prospective, double-blinded study to evaluate the efficacy and side effects of codeine with acetaminophen versus tramadol. Using a 10-day take-home diary, caregivers will be asked to record daily information about their child's postoperative pain and other core outcomes and domains as recommended in the recent consensus statement put forth by the Pediatric Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials (IMMPACT) (McGrath et al., 2008). This study will offer new information regarding the efficacy and side effects associated with tramadol as compared with codeine/acetaminophen (the current practice standard) in a pediatric population.

Hypotheses

H1: Children who receive scheduled tramadol following tonsillectomy will report better pain control than children who receive scheduled codeine/acetaminophen.

H2: Children who receive scheduled tramadol following tonsillectomy will report fewer side effects than children who receive scheduled codeine/acetaminophen.

Comparison of the Efficacy of Oral Oxycodone and Oral Codeine in the Treatment of Postcraniotomy Pain [Recruiting]
The efficacy of codeine is dependent on its demethylation to morphine. This extent of demethylation has wide inter-individual variability, making codeine's efficacy as a analgesic variable. Oxycodone is a semi-synthetic opioid and is a weak agonist on mu opioid receptors.

Codeine has been the mainstay of analgesia for patients after craniotomy for many years. Traditionally, craniotomies were not thought to be very painful procedures, hence the use of codeine, a moderately potent opioid (when compared to morphine).

However, in recent years, it has been found that up to 70% of post-craniotomy patients have moderate to severe pain and codeine did not provide adequate analgesic relief. Many studies have compared codeine to other drugs such as PCA morphine, fentanyl and tramadol, and patients on these stronger opioids generally had lower pain scores and better satisfaction.

No study has been conducted to determine the efficacy of analgesia of oral oxycodone to oral codeine.

Hence, the hypothesis is that oxycodone is more effective than codeine in providing pain relief in post-craniotomy patients.

Analgesic Effect of Paracetamol, Paracetamol + Codeine, Ibuprofen and Their Combination [Recruiting]
The purpose of this study is to determine whether the combination of paracetamol (acetaminophen) and other NSAIDs with or without weak opioids can give synergistic analgesic effect.

Codeine in Mechanically Ventilated Neonates [Recruiting]
The purpose of this study is to determine the absorption and bioavailability of codeine in relation to postnatal (PNA) and postconceptional (PCA) age; determine the parent drug (codeine), its active metabolites, their formation rates and their ratios in relation with PCA and PNA; and identify relevant genetic polymorphisms of opioid metabolism in the study population and their potential relationship to the biodisposition and pharmacodynamic effects of codeine. The study population is intubated and mechanically ventilated infants equal to or greater than 26 weeks gestational age at birth and less than 4 weeks postnatal age.

Codeine in Sickle Cell Disease [Recruiting]
The objective of this study is to determine if a subject’s genetic make-up would affect the treatment response to codeine in subjects with sickle cell disease.

more trials >>

Reports of Suspected Codeine Side Effects

Drug Hypersensitivity (71)Vomiting (17)Toxicity TO Various Agents (14)Nausea (13)Pain (11)Abdominal Distension (11)Drug Abuse (10)Cardio-Respiratory Arrest (10)Completed Suicide (9)Dyspnoea (9)more >>


Page last updated: 2014-04-12

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