Codeine contraindications

Alternative products to diclofenac include naproxen and mefenamic acid, both of which are non-steroidal anti-inflammatory drugs. Co-codamol is a mixture of the opioid analgesic codeine and paracetamol and it does not possess the anti-inflammatory component. It may be used in pain management either where NSAIDs are contraindicated or in patients who are intolerant to the effects of NSAIDs. 

Oxycodone is nearly 10 times as strong as codeine, with absorption equal to that of orally administered morphine. Neither hydromorphone nor oxycodone is approved for use in children, and hydromorphone is contraindicated in obstetrical analgesia and in asthmatics. 

Codeine and morphine are contraindicated in acute respiratory depression, acute alcoholism and where there is a risk of paralytic ileus. They should also be avoided in patients with raised intracranial pressure or head injury and in comatose patients. 

Codeine and morphine should also be used with caution in convulsive disorders and if a patient is dependent on opioids, they should not be withdrawn abruptly. (See BNF for further cautions and contraindications.)... 

Contraindications. Contraindications include hypersensitivity to opioids, head trauma or increased intracranial pressure, severe respiratory depression or compromised respiratory function, and potentially, liver or renal insufficiency (46). Whether morphine or other opioids are used depends on the severity of the contraindication, and the potential benefits must be weighed relative to the risk. Anaphylactoid reactions have been reported after morphine or codeine administered i.v., although the reactions are rare (23). Morphine... 

Antitussives are contraindicated in patients with known hyiDersensitivily to the dru. The narcotic antitussives (tliose with codeine) are contraindicated in premature infants or during labor when delivery of a premature infant is anticipated. Codeine is a Piregnancy Category C drug except in the pr nant woman at term or when taken for extended periods, when it is considered a Pr iancy Category D drug. 

Known hypersensitivity to oxymorphone hydrochloride, morphine analogs such as codeine, or any of the other ingredients of OPANA, moderate or severe hepatic impairment and any situation where opioids are contraindicated such as patients with respiratory depression (in the absence of resuscitative equipment or in unmonitored settings), acute or severe bronchial asthma, hypercarbia, and in any patient who has or is suspected of having paralytic ileus. 

Zahoor A, Mateger M, Ahmad N. Is previous cholecystectomy a contraindication to paracetamol/codeine premedication Euro J Anaesthe-siol March 2013 30(3) 131-2. 

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