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A reminder to parents that Codeine is not safe for kids. In Australia this includes Painstop medication.

The American Academy of Paediatrics issued a statement this week urging parents and doctors to stop giving children under the age of 18 both prescription and over-the-counter medications that include codeine, such as cough syrup and pain relievers.

“People have this very false misconception about codeine, thinking that it’s safer than other opioids,” Dr. Joseph Tobias, one of the study’s lead authors, told The Huffington Post. “Our whole push for writing this manuscript was to educate clinicians and push regulatory boards to pull codeine off the market for paediatric patients.”

U.S. researchers found codeine to be linked to rare but life-threatening and fatal breathing reactions in children.

“An opioid drug used for decades in prescription pain medicines and over-the-counter cough formulas, codeine is converted by the liver into morphine. Because of genetic variability in how quickly an individual’s body breaks down the drug, it provides inadequate relief for some patients while having too strong an effect on others.  Certain individuals, especially children and those with obstructive sleep apnea, are “ultra-rapid metabolizers” and may experience severely slowed breathing rates or even die after taking standard doses of codeine.”

In Australia in 2013 safety concerns were raised over use of codeine and codeine-containing medicines in children after reports of respiratory depression, including some fatalities. New guidelines and contraindications have been issued by international regulatory bodies, including the FDA, EMA and MHRA following safety reviews. The TGA is aware of the actions of other regulators and is continuing to review the available information to determine whether any action is required in Australia.

The EMA safety review concluded that codeine and codeine-containing medicines should only be used to treat moderate pain of short duration in children over 12 years of age, and only if the pain cannot be relieved by other painkillers such as paracetamol or ibuprofen.

It was recommended that doctors when prescribing codeine, consider the following new international guidance.

  • Do not use codeine to treat pain in children aged under 18 after tonsillectomy and/or adenoidectomy. Consider alternative analgesics.
  • Only use codeine to treat moderate pain of short duration in children over 12 years and only if it cannot be relieved by other analgesics such as paracetamol or ibuprofen.
  • Do not use codeine in adults or children known to be ultra-rapid metabolisers of codeine.
  • If codeine is prescribed, use the lowest dose for the shortest time possible. Avoid round-the-clock dosing.
  • If codeine is prescribed, advise parents or carers to monitor for signs of morphine toxicity (such as unusual sleepiness, confusion, small pupils, nausea or vomiting, constipation, lack of appetite or difficult or noisy breathing) and seek immediate medical attention if these occur.
  • Report adverse events to the TGA.

One of the common codeine products for children on the market in Australia today is Painstop for Children Night-Time Pain Reliever Syrup. and Painstop For Children Day-Time Pain Reliever Syrup. Please be careful with dosage and read instructions carefully. You can find more info here.

The study urges parents and clinicians to reach for other pain relievers such as Motrin, Tylenol and Ibuprofen instead.

“There is no benefit to codeine and potential risk, and it makes little medical sense to be using this in children,” said Dr. Rebecca Rosenberg. “Codeine is also not that effective as a pain medication. Very few people respond to it.”

Share your comments below.

Image via shutterstock photo

  • Always check medications with the pharmacist first when using with small children.

    Reply

  • You can purchase Panadol Forte which has Codeine without a prescription.
    If you ask for it I doubt the pharmacist is going to warn you about the danger of it……………I’m not saying this is available in a Supermarket but there is plenty of medicinal products that shouldn’t be sold by them.

    Reply

  • This is very important reminder.

    Reply

  • Any Medication containing codeine regardless of what is going to be used to treat should be behind the pharmacy counter and by prescription only. Perhaps it should be issued via Govt. approval only.

    Reply

  • Caution is best with all medications and following the advice of a chemist.

    Reply

  • That’s scary. Codeine for adults is bad enough, and can be very addictive. Children should in no way use codeine, paracetamol is enough!


    • Codeine does have to be used very carefully, but some people are just not aware of the impact of codeine,

    Reply

  • i think you can only get it on prescription which is good so it stops people using it with out realising the bad effects it has,

    Reply

  • Wow so many of my mum friends use painstop all the time to get their children to sleep. This is a scary article to read.

    Reply

  • Codeine needs to be taken with caution and you would think children’s products wouldn’t contain it.

    Reply

  • I would never have imagined it was in children’s products!?

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  • We do not use a lot of pain medication and certainly not with codeine.

    Reply

  • There should be a warning on the label.

    Reply

  • As a codeine with a good tolerance of codeine I still don’t feel safe taking it sometimes. It is definitely not for children


    • **Person* lol I am quite unwell with the flu, I am blaming that

    Reply

  • I would never give it to a child.
    My mum is allergic to codene

    Reply

  • I have always thought Codeine was to only been used in extreme circumstances if prescribed by a doctor.. I would never see it as a first option and i am shocked anyone would in regards to a child…

    Reply

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