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Codeine

Overview

Codeine (Phosphate) is the 3-methyl ether of morphine. It can be obtained from opium, present in a concentartion of less than 0.5% or synthesized by methylation of morphine.a narcotic analgesic (relieves the pain without causing sleep). Codeine (Phosphate) is used to relieve mild to moderate pain. it is also used as a cough suppressant.

Category:

Primary Characterstics

Molecular Structure of Codeine
Codeine (Phosphate) is the derivative of Codeine. It is of Semi Synthetic origin and belongs to Opioid. It belongs to OPIATE agonist pharmacological group on the basis of mechanism of action and also classified in Analgesic pharmacological group.The Molecular Weight of Codeine is 406.40.
It is weakly acidic drug, 7.29% solution of the drug is isotonic and Its pKa is 8.2.

Pharmacokinetics

Oral absorption of Codeine is found to be 94% ±4. Volume of distribution is found to be 3.6 l/kg and plasma protien binding is 7-25%. Presystemic metabolism is noted to be 50% and metabolism is reported hepatic. Renal Excretion accounts for major and plasma half life is 3-4 hr.

Indications

Codeine is primarily indicated in conditions like Cough, Diarrhoea, Mild to moderate pain, and can also be given in adjunctive therapy as an alternative drug of choice in Anxiety, Control of agitated states in elderly without confusion.

Contraindications

Codeine is contraindicated in conditions like Asthma,Respiratory depression,Raised intracranial pressure.

Drug Interactions

Codeine is known to interact with other drugs, the details of drug interactions is as follows:

DrugDetailsSeverityOnsetManagement
Alcohol
Moclobemide
Nefopam (HCl)
Paroxetine
PericyazineThese drugs shouldnot be taken concurrently without doctors prescription.

These interactions are sometimes beneficial and sometimes may pose threats to life. Always consult your physician for the change of dose regimen or an alternative drug of choice that may strictly be required.

Interference in Pathology

  • Tests for the estimation of Alkaloids, Morphine and Barbiturates in urine.

Side Effects

The severe or irreversible adverse effects of Codeine, which give rise to further complications include Hallucinations.

Codeine produces potentially life-threatening effects which include Respiratory depression. which are responsible for the discontinuation of Codeine therapy.

The signs and symptoms that are produced after the acute overdosage of Codeine include Hypotension, Convulsions, Respiratory depression, Deepening coma, Circulatory failure.

The symptomatic adverse reactions produced by Codeine are more or less tolerable and if they become severe, they can be treated symptomatically, these include Vertigo, Nausea, Vomiting, Palpitation, Constipation, Dry mouth, Bradycardia, Facial flushing, SweatingX, Miosis, Ureteric spasm, Biliary spasm, Mood changes.

Available Brands

Multi ingredient

Tabs: 15 mg, 20 mg, 30 mg, 250 mg,

Dosage

Codeine's dosage details are as follows:
Dose Single Dose Frequency Route Instructions

Adult Dosage

10 to 50 mg30 (30)6 hourlyPO

Paedriatic Dosage ( 20 Kg. )

250 ug/kg250 (250)6 hourlyOral-

Neonatal Dosage ( 3 Kg. )

No data regarding the neonatal dosage details of Codeine is available.

High Risk Groups

Drug should not be given to Paediatrics, Pregnant Mothers, and Neonates.

If prescribing authority justifies the benefits of the drug against the possible damages he/she should reevaluate them and consult the reference material and previous studies.

Warning / Precautions

Codeine phosphate should be used with caution, and reduced the initial dose in patients with acute abdominal conditions, convulsive disorders, kidney or liver impairment, fever, hypothyroidism, in patients with recent gastrointestinal or urinary tract surgery. It should be used with caution in very young or elderly patients.

Storage Conditions

Inj

Store at room temperature. Do not Freeze. Protect from Sunlight.

Tab, Oral Soln

Store Below 40°C. Protect from Sunlight and Moisture.

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