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Codeine

Medical Uses – Used to treat mild to moderate pain – Commonly used for post-surgical dental pain – Some evidence for cancer pain, but with […]

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Medical Uses

– Used to treat mild to moderate pain
– Commonly used for post-surgical dental pain
– Some evidence for cancer pain, but with increased adverse effects
– Not recommended for children by the American Academy of Pediatrics
– FDA lists age under 12 as contraindicated

Pain

– Treats mild to moderate pain
– Commonly used for post-surgical dental pain
– Weak evidence for cancer pain
– Increased adverse effects compared to other opioids
– Not recommended for children by the American Academy of Pediatrics

Cough

– Relieves coughing
– Not supported for acute cough suppression in children
– Not recommended in Europe for children under 12
– Tentative evidence for reducing chronic cough in adults

Diarrhea

– Treats diarrhea and diarrhea-predominant irritable bowel syndrome
– Loperamide more frequently used for milder diarrhea
– Codeine used for severe diarrhea
– Other alternatives include diphenoxylate, paregoric, or laudanum
– Codeine is not the first choice for diarrhea treatment

Formulations

– Marketed as single-ingredient drug and in combination preparations
– Combinations with paracetamol, aspirin, or ibuprofen for greater pain relief
– Also marketed with other painkillers and muscle relaxers
– Codeine-only products available with a prescription
– Injectable codeine available for subcutaneous or intramuscular injection

Codeine (Wikipedia)

Codeine is an opiate and prodrug of morphine mainly used to treat pain, coughing, and diarrhea. It is also commonly used as a recreational drug. It is found naturally in the sap of the opium poppy, Papaver somniferum. It is typically used to treat mild to moderate degrees of pain.[failed verification] Greater benefit may occur when combined with paracetamol (acetaminophen) or a nonsteroidal anti-inflammatory drug (NSAID) such as aspirin or ibuprofen. Evidence does not support its use for acute cough suppression in children or adults. In Europe, it is not recommended as a cough medicine in those under 12 years of age. It is generally taken by mouth. It typically starts working after half an hour, with maximum effect at two hours. Its effects last for about four to six hours. Codeine exhibits abuse potential similar to other opioid medications, including a risk of habituation and overdose.

Codeine
Skeletal formula
Ball-and-stick model
Clinical data
Pronunciation/ˈkdn/
Other names3-Methylmorphine
AHFS/Drugs.comMonograph
MedlinePlusa682065
Pregnancy
category
  • AU: A
Dependence
liability
High
Addiction
liability
High
Routes of
administration
By mouth, rectal, subcutaneous injection, intramuscular injection
Drug classOpioid
Antitussives
ATC code
Legal status
Legal status
Pharmacokinetic data
BioavailabilityOral: ~90%
MetabolismLiver: CYP2D6 (to morphine), CYP3A4 (to norcodeine), UGT2B7 (to 3- and 6-glucuronides of codeine, norcodeine, and morphine)
MetabolitesMorphine
Norcodeine
• Others (e.g., conjugates)
Onset of action15–30 minutes
Elimination half-life2.5–3 hours
Duration of action4–6 hours
Identifiers
  • (5α,6α)-7,8-didehydro-4,5-epoxy-3-methoxy-17-methylmorphinan-6-ol
CAS Number
PubChem CID
IUPHAR/BPS
DrugBank
ChemSpider
UNII
KEGG
ChEBI
ChEMBL
CompTox Dashboard (EPA)
ECHA InfoCard100.000.882 Edit this at Wikidata
Chemical and physical data
FormulaC18H21NO3
Molar mass299.370 g·mol−1
3D model (JSmol)
  • CN1CC[C@]23[C@@H]4[C@H]1CC5=C2C(=C(C=C5)OC)O[C@H]3[C@H](C=C4)O
  • InChI=1S/C18H21NO3/c1-19-8-7-18-11-4-5-13(20)17(18)22-16-14(21-2)6-3-10(15(16)18)9-12(11)19/h3-6,11-13,17,20H,7-9H2,1-2H3/t11-,12+,13-,17-,18-/m0/s1 ☒N
  • Key:OROGSEYTTFOCAN-DNJOTXNNSA-N checkY
 ☒NcheckY (what is this?)  (verify)

Common side effects include vomiting, constipation, itchiness, lightheadedness, and drowsiness. Serious side effects may include breathing difficulties and addiction. Whether its use in pregnancy is safe is unclear. Care should be used during breastfeeding, as it may result in opiate toxicity in the baby. Its use as of 2016 is not recommended in children. Codeine works following being broken down by the liver into morphine; how quickly this occurs depends on a person's genetics.

Codeine was discovered in 1832 by Pierre Jean Robiquet. In 2013, about 361,000 kg (795,000 lb) of codeine were produced while 249,000 kg (549,000 lb) were used, which made it the most commonly taken opiate. It is on the World Health Organization's List of Essential Medicines. Codeine occurs naturally and makes up about 2% of opium.


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