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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

PSA provides pharmacies with consumer information on safe use of non-prescription codeine
Source: Pain / Anesthetics News From Medical News Today [2015.03.26]
National President of the PSA, Grant Kardachi, says the PSA has produced a leaflet as one of its resources developed in response to increasing reports about the damaging effects of overuse of...

Coordination of Care Matters Most to Patients With Chronic Pain
Source: Medscape NeurologyHeadlines [2015.03.27]
A survey shows patients rank coordination of chronic pain management above the relationship with their healthcare provider, and outcomes correlate with the quality of coordination.
Medscape Medical News

Study identifies low back pain risk factors
Source: Bones / Orthopedics News From Medical News Today [2015.03.27]
Counseling at-risk patients may prevent and minimize painNew research presented at the 2015 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) identifies nicotine dependence...

New technique paints tissue samples with light
Source: Breast Cancer News From Medical News Today [2015.03.27]
One infrared scan can give pathologists a window into the structures and molecules inside tissues and cells, enabling fast and broad diagnostic assessments, thanks to an imaging technique developed...

Researchers discover a key mechanism of chronic inflammatory pain that could reduce drug doses
Source: Neurology / Neuroscience News From Medical News Today [2015.03.27]
A study led by Professor Lucía Hipólito, from the Department of Pharmacy and Pharmaceutical Technology of the University of Valencia, has revealed a new mechanism to treat chronic inflammatory...

more news >>

Published Studies Related to Codeine

Randomized clinical trial of hydrocodone/acetaminophen versus codeine/acetaminophen in the treatment of acute extremity pain after emergency department discharge. [2014]
(DEA) Schedule III narcotics... CONCLUSIONS: Both medications decreased NRS pain scores by approximately 50%.

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.

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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.

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.

A Study of Oral Codeine Sulfate in Pediatric Patients With Post-procedural Pain [Recruiting]
This is a multicenter, open-label study to evaluate the safety and PK of oral codeine sulfate in pediatric subjects with mild to moderate post-procedural pain.

Assessment of Opioid Analgesia in Sickle Cell [Recruiting]
To develop and validate a non-invasive, in vivo, phenotyping method for CYP2D6 using the non-injurious neuroselective electrical stimulation technique: pain perception threshold/pain tolerance threshold (PPT/PTT) in children and adolescents with sickle cell disease.

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.

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: 2015-03-27

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